Yoichi Akita

Histological changes and involvement of apoptosis after photodynamic therapy for actinic keratoses

Background  Photodynamic therapy (PDT), which employs a combination of a tumour‐localizing photosensitizer and visible light, has been used to treat superficial malignancies in the epidermis.

Photodynamic therapy for the treatment of actinic cheilitis

Although actinic cheilitis is a common disease, it should be treated carefully because it can undergo malignant transformation. We report a case of actinic cheilitis treated with photodynamic therapy (PDT) using 5‐aminolevulinic acid (ALA), with satisfactory outcome in both clinical and pathological aspects. Actinic cheilitis is a pathologic condition affecting mainly the lower lip caused by long‐term exposure of the lips to the UV radiation in sunlight. Analogous to actinic keratosis of the skin, actinic cheilitis is considered as a precancerous lesion and it may develop into squamous cell carcinoma. We report a case of actinic cheilitis treated with PDT using ALA, with satisfactory outcome in both clinical and pathological aspects.

A pilot study to assess the efficacy of photodynamic therapy for Japanese patients with actinic keratosis in relation to lesion size and histological severity

Background/purpose: Topical 5‐aminolevulinic acid (ALA)‐based photodynamic therapy (PDT) is effective for actinic keratosis (AK); few studies have examined Oriental patients. The aim of this study is to assess the efficacy of PDT for the treatment of Japanese AK patients classified by lesion size and histological severity.

Histological localization of aluminum in topical aluminum chloride treatment for palmar hyperhidrosis

Primary or secondary hyperhidrosis is excessive sweating beyond that required for returning body temperature to normal. It can be focal or generalized and commonly affects the underarms, Al specific binding fluorescence reagent and we investigated the mechanism of the antiperspirant action of AC. Palmar hyperhidorosis patients (n = 127) were topically treated with 20% AC solution without occlusion once a day for 1 month. Collection of subjects from patients was based on informed consent and declaration of Helsinki principles received approval of the ethical committee in Aichi Medical University School of Medicine (No. 11-014). First, sweat production was measured by palms, soles or face [1]. The disease often significantly affects the patient’s quality of life. Treatment options include topical aluminum chloride (AC), iontophoresis, botulinum toxin A, oral anticholinergics, and endoscopic sympathectomy. Topical AC is a well-established therapy for hyperhidrosis and is the first-line therapy for mild to moderate disease [2]. The mechanism of the action of aluminum (Al) salt in the forearm or axilla has been investigated in a few studies [3,4]. However, there has been no report on the mechanism of the antiperspirant action of AC for treatment of palmoplantar hyperhidrosis. In this study, we investigated the histological localization of Al for palmar hyperhidorosis by using an

Photodynamic therapy using direct‐current pulsed iontophoresis for 5‐aminolevulinic acid application

In photodynamic therapy (PDT) for skin cancer, 5‐aminolevulinic acid (ALA) is applied topically to the affected area to be absorbed percutaneously through passive diffusion, and typically requires 4–6 h before performing PDT. In this study, we attempted to reduce the absorption period in PDT by ionizing ALA using direct‐current pulsed iontophoresis to treat actinic keratosis (AK). Twenty percent ALA solution was applied to AK lesions of five patients using direct‐current pulsed iontophoresis. ALA‐PDT was repeated three times with a total irradiation of 150 J/cm2 (50 J/cm2 per irradiation, weekly). One week after the last PDT, therapeutic results were assessed by skin biopsy. In all subjects, protoporphyrin IX (PpIX) production was confirmed after iontophoresis, and its production levels were comparable to the conventional occlusive dressing technique (ODT). Skin biopsies from the treated lesion showed the disappearance of tumour cells. These results indicated that direct‐current pulsed iontophoresis for applying ALA before PDT is useful to treat AK.

Etretinate enhances the susceptibility of human skin squamous cell carcinoma cells to 5-aminolaevulic acid-based photodynamic therapy

Background.  Photodynamic therapy (PDT) with 5‐aminolaevulinic acid (5‐ALA) is a noninvasive and effective treatment for superficial skin cancers. Etretinate, a derivate of vitamin A, with the chemical formula ethyl(2E,4E,6E,8E)‐9‐(4‐methoxy‐2,3,6‐trimethylphenyl)‐3,7‐dimethyl‐2,4,6,8‐nona‐tetraenoate, has been reported to have antitumour effects and to regulate the proliferation and differentiation of skin cancers.

Comparison of the efficacy of ALA‐PDT using an excimer‐dye laser (630 nm) and a metal‐halide lamp (600 to 740 nm) for treatment of Bowen's disease

Topical 5‐aminolevulinic acid‐based photodynamic therapy (ALA‐PDT) is an effective treatment for Bowens disease (BD). In order to compare the efficacy of two different light sources, using either an excimer‐dye laser (EDL) (630 nm) or a metal‐halide lamp (MHL) (600 to 740 nm) a protocol for topical ALA‐PDT for treatment of BD of the extremities was established, and responses during 12 months follow‐up were assessed.

Thioredoxin upregulation by 5-aminolaevulinic acid-based photodynamic therapy in human skin squamous cell carcinoma cell line

Background/purpose: 5‐aminolaevulinic acid‐based photodynamic therapy (ALA‐PDT) is widely performed in the clinical setting for superficial skin cancers, giving favorable results, but residual tumor and recurrence occur occasionally. Thioredoxin is a common antioxidant that suppresses apoptosis and facilitates cell growth. We investigated the expression of thioredoxin following ALA‐PDT in human skin squamous cell carcinoma cell line, HSC‐5.

Evaluation of the antihistamine effects of olopatadine and levocetirizine during a 24-h period: A double-blind, randomized, cross-over, placebo-controlled comparison in skin responses induced by histamine iontophoresis

The antihistamine effects of olopatadine and levocetirizine, in standard‐dose application described in their information (5 mg twice a day for olopatadine; 5 mg once daily for levocetirizine), were examined from 11.5 to 24 h after application. The test was designed in a double‐blind, randomized, cross‐over, placebo‐controlled study of 12 healthy volunteers on histamine‐induced flare and wheal response using an iontophoresis technique. The suppressive effect of olopatadine on the wheals induced by a 0.1‐mA histamine iontophoresis lasted for 24 h after dosing. Both drugs inhibited flare induced by histamine iontophoresis almost completely until 24 h after the first administration. Suppression of the 0.2‐mA‐induced wheal response by levocetirizine, taken once daily, decreased with time, although 0.1‐mA‐induced flare was almost completely suppressed by the drug. Olopatadine completely suppressed even the wheal response induced by a 0.2‐mA histamine iontophoresis. Compared with the placebo, the two drugs significantly suppressed the subjective itching assessed by visual analog scale at all intervals. There were no significant differences in subjective drowsiness and objective cognitive function between drug‐ and placebo‐treated subjects. These results demonstrate that olopatadine seems to be more potent than levocetirizine when administrated in a standard dose. In conclusion, mild to moderate urticaria could be controlled by standard application as described in their information. On the other hand, severe urticaria could be managed by a standard application of olopatadine, but levocetirizine may need an additional dose to control severe urticaria.

The effect of psoralen plus ultraviolet A in vitro in HUT-78 enhances by 5-aminolevulinic acid.

Background: Sezary syndrome and mycosis fungoides are forms of cutaneous T‐cell lymphoma, and in the early stage of these diseases psoralen plus ultraviolet A (PUVA) is one of the treatments of choice. Photodynamic therapy using 5‐aminolevulinic acid (ALA‐PDT) is an effective, non‐invasive, and safe treatment for most superficial skin cancers. In order to obtain greater efficacy of PUVA, we investigated the synergistic anti‐tumor effects of ALA‐PDT and PUVA using 8‐methoxypsoralen (8‐MOP) and a UVA lamp.