Outdoor testing of the photoprotection provided by a new water-based broad-spectrum SPF50+ sunscreen product: Two double-blind, split-face, randomized controlled studies in healthy adults

Purpose: Users often under-apply sunscreens, and one of the main reasons cited for this is the cosmetic formulation of the product. To address this, we developed a water-based sunscreen. The product underwent standard laboratory testing (ISO 24444: 2010) and was determined as sun protection factor (SPF) 50+. However, such laboratory testing does not take into account environmental factors of in-use conditions that could potentially affect sunscreen efficacy, particularly of new cosmetic formulations. We aimed to test this product in conditions more representative of real-life solar exposure, to confirm its reported laboratory efficacy. Methods: Two double-blind, randomized, controlled, split-face intra-individual studies were conducted during summer months in Barcelona. One study compared the product against an SPF15 control (reference standard P3 of ISO 24444: 2010), while the other compared against an SPF50+ control (another commercially available sunscreen). A technician applied the products before sun exposure: investigational product (IP) to one half of the face and the respective control product to the other. Subjects spent 4–6 hrs outdoors performing quiet activities, and sunscreens were reapplied at 2 hourly intervals. A dermatologist clinically scored facial erythema at baseline and at 24 hrs. Results: Sixty-five subjects were included in total. In both studies, skin treated with the IP showed no significant increase in clinical erythema scoring at 24 hrs. There were statistically significant differences between the IP and the SPF15, but not between the IP and the SPF50+ control. SPF15 did not protect all subjects against solar-induced erythema. Conclusion: These outdoor studies confirm the efficacy of this new SPF50+ water-based sunscreen in conditions that closer represent real-life sun exposure

Photodynamic therapy (PDT) in oncology

The issue is focused on Photodynamic Therapy (PDT), which is a minimally invasive therapeutic modality approved for treatment of several types of cancer and non-oncological disorders. PDT is being used in dermatology for the treatment of non-melanoma skin cancers (basal cell carcinoma, BCC, and Bowen disease, BD) and precancerous lesions (actinic keratosis, AKs), among other tumors such as: head and neck cancer and bladder and gynaecological neoplasms. PDT can also be used for cancer diagnosis by means of theragnosis (a term arising from the combination of diagnostic tests and therapy), a promising technique based on targeted fluorescent imaging and PDT. Photofrin and aminolevulinic acid and its ester derivatives are the main compounds used in clinical trials although newer photosensitizers (PSs) and delivery tools are being evaluated. This Special Issue on Cancers includes original articles on photochemical mechanisms, new PSs and delivery tools, cellular and tissue targets, cellular response (cell death or survival), vascular damage and immune response. We hope all the articles published in this Special Issue can help to improve this therapeutic cancer modality

In vitro effect of photodynamic therapy with different lights and combined or uncombined with chlorhexidine on Candida spp.

Candidiasis is very common and complicated to treat in some cases due to increased resistance to antifungals. Antimicrobial photodynamic therapy (aPDT) is a promising alternative treatment. It is based on the principle that light of a specific wavelength activates a photosensitizer molecule resulting in the generation of reactive oxygen species that are able to kill pathogens. The aim here is the in vitro photoinactivation of three strains of Candida spp., Candida albicans ATCC 10231, Candida parapsilosis ATCC 22019 and Candida krusei ATCC 6258, using aPDT with different sources of irradiation and the photosensitizer methylene blue (MB), alone or in combination with chlorhexidine (CHX). Irradiation was carried out at a fluence of 18 J/cm2 with a light-emitting diode (LED) lamp emitting in red (625 nm) or a white metal halide lamp (WMH) that emits at broad-spectrum white light (420–700 nm). After the photodynamic treatment, the antimicrobial effect is evaluated by counting colony forming units (CFU). MB-aPDT produces a 6 log10 reduction in the number of CFU/100 μL of Candida spp., and the combination with CHX enhances the effect of photoinactivation (effect achieved with lower concentration of MB). Both lamps have similar efficiencies, but the WMH lamp is slightly more efficient. This work opens the doors to a possible clinical application of the combination for resistant or persistent forms of Candida infections

Editorial: Antimicrobial Photodynamic Therapy: A New Paradigm in the Fight Against Infections

According to a 2019 report from the Center for Disease Control and Prevention (CDC), more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35, 000 people die as a result. This special issue is focused on Antimicrobial Photodynamic Therapy (PDT), which is a new strategy to fight against infections. PDT is mostly used in the treatment of cancer, and non-melanoma skin cancer is the most widely recognized indication. A photosensitizer that is activated by visible light in the presence of oxygen can generate reactive oxygen species resulting in the death of the microorganisms, without damaging the surrounding tissue. This innovative way of destroying microbial pathogens has many advantages compared with the conventional antimicrobials and antibiotics used so far. It has a broad spectrum of action, being able to kill or inactivate bacteria, fungi, viruses and protozoa..

Colonization With Staphylococcus aureus in Atopic Dermatitis Patients: Attempts to Reveal the Unknown

Atopic dermatitis (AD) patients are massively colonized with Staphylococcus aureus (S. aureus) in lesional and non-lesional skin. A skin infection may become systemic if left untreated. Of interest, the incidence of multi-drug resistant S. aureus (MRSA) in AD patients is higher as compared to a healthy population, which makes treatment even more challenging. Information on the specific genetic background of S. aureus accompanying and/or causing AD flares would be of great importance in terms of possible treatment option development. In this review, we summarized the data on the prevalence of S. aureus in general in AD skin, and the prevalence of specific clones that might be associated with flares of eczema. We put our special interest in the presence and role of staphylococcal enterotoxins as important virulence factors in the epidemiology of AD-derived S. aureus. Also, we summarize the present and potentially useful future anti-staphylococcal treatment

In vitro effect photodynamic therapy with differents photosensitizers on cariogenic microorganisms

Background Antimicrobial photodynamic therapy has been proposed as an alternative to suppress subgingival species. This results from the balance among Streptococcus sanguis, Streptococcus mutans and Candida albicans in the dental biofilm. Not all the photosensitizers have the same photodynamic effect against the different microorganims. The objective of this study is to compare in vitro the photodynamic effect of methylene blue (MB), rose Bengal (RB) and curcumin (CUR) in combination with white light on the cariogenic microorganism S. mutans, S. sanguis and C. albicans. Go to: Results Photodynamic therapy with MB, RB and CUR inhibited 6 log 10 the growth of both bacteria but at different concentrations: 0.31–0.62 μg/ml and 0.62–1.25 μg/ml RB were needed to photoinactivate S. mutans and S. sanguis, respectively; 1.25–2.5 μg/ml MB for both species; whereas higher CUR concentrations (80–160 μg/ml and 160–320 μg/ml) were required to obtain the same reduction in S. mutans and S. sanguis viability respectively. The minimal fungicidal concentration of MB for 5 log10 CFU reduction (4.5 McFarland) was 80–160 μg/ml, whereas for RB it ranged between 320 and 640 μg/ml. For CUR, even the maximum studied concentration (1280 μg/ml) did not reach that inhibition. Incubation time had no effect in all experiments. Go to: Conclusions Photodynamic therapy with RB, MB and CUR and white light is effective in killing S. mutans and S. sanguis strains, although MB and RB are more efficient than CUR. C. albicans required higher concentrations of all photosensitizers to obtain a fungicidal effect, being MB the most efficient and CUR ineffective.España, Ministerio de Ciencia e Innovación CTQ2013-48767-C3-2-

Photodynamic Therapy Combined with Antibiotics or Antifungals against Microorganisms That Cause Skin and Soft Tissue Infections: A Planktonic and Biofilm Approach to Overcome Resistances

The present review covers combination approaches of antimicrobial photodynamic therapy (aPDT) plus antibiotics or antifungals to attack bacteria and fungi in vitro (both planktonic and biofilm forms) focused on those microorganisms that cause infections in skin and soft tissues. The combination can prevent failure in the fight against these microorganisms: antimicrobial drugs can increase the susceptibility of microorganisms to aPDT and prevent the possibility of regrowth of those that were not inactivated during the irradiation; meanwhile, aPDT is effective regardless of the resistance pattern of the strain and their use does not contribute to the selection of antimicrobial resistance. Additive or synergistic antimicrobial effects in vitro are evaluated and the best combinations are presented. The use of combined treatment of aPDT with antimicrobials could help overcome the difficulty of fighting high level of resistance microorganisms and, as it is a multi-target approach, it could make the selection of resistant microorganisms more difficult

Crown vessels and shiny white structures in dermoscopy of histoid leprosy

INTRODUCTION Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with varied clinical presentations. Owing to its low incidence, together with its myriad clinical presentations, leprosy poses a diagnostic challenge and can easily be confused with other infective and noninfective granulomatous dermatoses.1 Dermoscopy is a simple and noninvasive technique that is widely used for the diagnosis and monitoring of melanoma and nonmelanoma skin cancers and many inflammatory disorders. However, the utility of this technique for the diagnosis of granulomatous diseases has only recently been demonstrated.2 Although dermoscopy shows diagnostically useful patterns in infections and inflammatory diseases with granulomatous presentations, the dermoscopic features of leprosy are poorly documented in the literature. CASE REPORT A 45-year-old Moroccan man who lived in Spain for many years, but frequently visited his country of origin, was seen at the dermatology service for skin lesions on the trunk and upper and lower extremities. The lesions, which appeared 5 years earlier, were progressive in nature, caused intense itching, and were treated with topical corticosteroids and oral antihistamines without improvement. The patient had undergone analyses 3 years earlier, but no..

Granuloma annulare: report of 13 patients treated with photodynamic therapy

Dear Editor, Granuloma annulare (GA) is a benign in?ammatory granuloma- tous skin. Photodynamic therapy (PDT) has been described as another therapeutic option for localized GA, with a degree of recommendation B. Therefore, we have carried out a review of all patients with GA treated with PDT in our Dermatology Unit. We performed a retrospective observational study in San Jorge Hospital (Huesca, Spain) including all patients diagnosed with GA and treated with PDT between 2007 and 2018. Diagno- sis of GA was clinical and a skin biopsy was performed if it was necessary. In all patients, methyl aminolevulinate (MAL) or aminolevulinic acid (ALA) was applied under occlusive and opa- que dressing for 3 h and illuminated with LED 635 nm (Aktilite?, Uppsala, Sweden) with a ?uence of 37 J/cm . The lesions were prepared by a soft curettage or microneedling, and some lesions did not receive any kind of prior skin preparation. Continuous variables were described using means and standard deviations. Statistical analyses were carried out using SPSS soft- ware (version 20.0; IBM Corp, Armonk, NY, USA). Thirteen patients were included in the study (Table 1). Eleven cases (84.6%) were women and two men (15.4%), with a mean of 53 years old. Eighty-four per cent patients (n = 11) ..

The use of HSQoL-24 in an assessment of quality-of-life impairment among hidradenitis suppurativa patients: First look at real-life data

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with well-documented effects on patients’ quality of life (QoL). The aim of this study was to evaluate the QoL of patients with HS via the use of a newly developed questionnaire: Hidradenitis Suppurativa Quality of Life-24 (HSQoL-24). This study was performed on a population of 342 HS patients. Their QoL was assessed via the HSQoL-24 questionnaire. The perceived impairment of QoL due to HS in the studied group was considered to be serious (mean HSQoL-24 score: 58.3 ± 21.0 points). Women tended to experience a significantly higher impact from the disease than men (61.6 ± 19.2 points vs. 51.1 ± 23.1 points, p < 0.001). The HS severity had an effect on the perceived QoL, with statistically significant differences being evident between the self-assessed HS severity groups. The level of QoL impairment correlated positively with the number of affected body areas (r = 0.285, p < 0.001) and the duration of the disease (r = 0.173, p = 0.001), while the patients’ age at disease onset correlated negatively with the HSQoL-24 global score (r = -0.182, p = 0.001). Patients living in their family house scored higher than other groups. The least affected were patients who lived alone. The study shows that the HSQoL-24 questionnaire is a reliable, HS-specific tool for measuring the QoL among patients with HS in real-life clinical settings. © 2021 by the authors. Licensee MDPI, Basel, Switzerland