M A Fadel1, A A Tawfik. 1. Drug Delivery and Nanotechnology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (NILES), Cairo University, Cairo, Egypt.
Abstract
BACKGROUND: Hidradenitis suppurativa (HS), is a chronic, recurrent dermatosis affecting skin that contains apocrine glands. Photodynamic therapy using aminolaevulinic acid (ALA) activated by intense pulsed light (IPL) have shown variable success rates, with some adverse effects. AIMS: To evaluate the efficacy and safety of methylene blue (MB) as a photosensitizer delivered as a niosomal gel for the treatment of HS using IPL. METHODS: We enrolled 11 patients with HS in the study, which was a randomized split-body study. One side of each patient's body was treated with niosomal MB (NMB) gel and the other side was treated with unloaded (free) MB (FMB) gel. The affected sites were irradiated using IPL with a 630 nm filter. Patients were followed up at 1, 3 and 6 months after treatment. RESULTS: Drug release from the FMB gel was significantly higher (P > 0.05) than from the NMB gel. Lesions showed 77.3% and 44.1% reduction on the NMB and FMB sides, respectively. A significant reduction in the Hidradenitis Suppurativa Lesion, Area and Severity Index (HS-LASI) after treatment was elicited in both groups, with no pain, erythema or hyperpigmentation. CONCLUSION: The combination of MB as a photosensitizer activated with 630 nm IPL as a light source is a successful PDT for HS. Delivery of MB in niosomes was more effective for drug penetration to the dermis compared with delivery by FMB gel. The 630 nm filter was not only a source of activation of MB but also a means of hair-follicle destruction.
RCT Entities:
BACKGROUND:Hidradenitis suppurativa (HS), is a chronic, recurrent dermatosis affecting skin that contains apocrine glands. Photodynamic therapy using aminolaevulinic acid (ALA) activated by intense pulsed light (IPL) have shown variable success rates, with some adverse effects. AIMS: To evaluate the efficacy and safety of methylene blue (MB) as a photosensitizer delivered as a niosomal gel for the treatment of HS using IPL. METHODS: We enrolled 11 patients with HS in the study, which was a randomized split-body study. One side of each patient's body was treated with niosomal MB (NMB) gel and the other side was treated with unloaded (free) MB (FMB) gel. The affected sites were irradiated using IPL with a 630 nm filter. Patients were followed up at 1, 3 and 6 months after treatment. RESULTS: Drug release from the FMB gel was significantly higher (P > 0.05) than from the NMB gel. Lesions showed 77.3% and 44.1% reduction on the NMB and FMB sides, respectively. A significant reduction in the Hidradenitis Suppurativa Lesion, Area and Severity Index (HS-LASI) after treatment was elicited in both groups, with no pain, erythema or hyperpigmentation. CONCLUSION: The combination of MB as a photosensitizer activated with 630 nm IPL as a light source is a successful PDT for HS. Delivery of MB in niosomes was more effective for drug penetration to the dermis compared with delivery by FMB gel. The 630 nm filter was not only a source of activation of MB but also a means of hair-follicle destruction.
Authors: Ali Alikhan; Christopher Sayed; Afsaneh Alavi; Raed Alhusayen; Alain Brassard; Craig Burkhart; Karen Crowell; Daniel B Eisen; Alice B Gottlieb; Iltefat Hamzavi; Paul G Hazen; Tara Jaleel; Alexa B Kimball; Joslyn Kirby; Michelle A Lowes; Robert Micheletti; Angela Miller; Haley B Naik; Dennis Orgill; Yves Poulin Journal: J Am Acad Dermatol Date: 2019-03-11 Impact factor: 15.487
Authors: John R Ingram; Pick-Ngor Woo; Ser Ling Chua; Anthony D Ormerod; Nemesha Desai; Anneke C Kai; Kerry Hood; Tara Burton; Francisco Kerdel; Sarah E Garner; Vincent Piguet Journal: Cochrane Database Syst Rev Date: 2015-10-07
Authors: J R Ingram; P N Woo; S L Chua; A D Ormerod; N Desai; A C Kai; K Hood; T Burton; F Kerdel; S E Garner; V Piguet Journal: Br J Dermatol Date: 2016-03-30 Impact factor: 9.302