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Facial rejuvenation using novel topical aminolevulinic acid ester
P3108
P3110
Change of cathepsin K activity in human skin in vivo after chronic ultraviolet damage Zhangzhang Ye, MD, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Wei Lai, MD, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Sunscreen use and sun exposure in a population of Japanese females Akira Kawada, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Kana Ishihara, Professional Product Planning Division, Marketing Department, Rohto Pharmaceutical, Tokyo, Japan; Naoki Oiso, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Shigeru Kawara, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Tomohiko Narita, MD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan
Objective: Photoaging is histologically characterized by the accumulation of abnormal elastin-containing material and disorganization of decreased bundles of collagen fibers. The fundamental mechanisms are still poorly understood. So far, most of the photoaging studies are focused on matrix metalloproteinases (MMPs). It was described that cathepsin K (catK) might play an important role in mediating intracellular elastin degradation.We hypothesize that catK may be related to ECM homeostasis in photoaging. We therefore studied the activity of catK in human skin in response to chronic SSR. Methods: Eight healthy Chinese volunteers (4 males and 4 females) were enrolled in the study after signing an informed consent that was approved by the medical ethics committee in our hospital ([2009]2-2). They were 21 to 26 years old with Fitzpatrick skin phototypes III or IV. The untanned upper buttock region was used as the site for exposure. The random side of upper buttock region was exposed to 1 MED of SSR (spectrum of 290-400 nm, 30% UVA + 70% UVB) per exposure every day for 5 successive days/week for 6 weeks. The other side of the upper buttock received no irradiation as control.The specific cathepsin K substrate, z-Leu-Arg-7-amido-4-methyl coumarin, was used. The fluorescence which the cleavage product emitted was recorded at 360 nm. The activity of catK was determined by the intensity of the fluorescence. All measurements were done in triplicate. Statistical significance was determined by using the paired samples t test. Calculations were performed using SPSS 17.0. Statistical significance was set at P \.05.
Chronic exposure to sunlight causes photoaging. Sunscreens are used to prevent the skin from photoaging and acute sun damage. To elucidate the relationship between photoaging and sun exposure, we investigated photoaging signs, sun exposure history, and sunscreen use in 514 Japanese females using an online interview on October 19 and 20, 2009. The largest number of subjects belonged to Japanese skin type (JST) class J-II (53%), J-I was second (31%), and J-III was third (16%). Fifty-seven and 45% had worrisome fleckles and wrinkles, respectively. A group with much and moderate sun exposure significantly had worrisome fleckles more than a group with minimum and little sun exposure (P \ .01). Frequency of sun exposure had no significant relation to presence of worrisome wrinkles. Eighty-seven percent knew sun protection factor (SPF), but 86% of them had not accurate understanding the definition of SPF. Seventy-four percent knew protection grade of UVA (PA), but 91% of them did not understand the definition of PA. This study showed that a relationship between fleckles and sun exposure history and insufficient knowledge of SPF and PA in a population of Japanese females. Commercial support: None identified.
Results: Chronic SSR exposure for 6 weeks induced a significant clinical and histologic change of chronic photodamage. The result showed that the average activity of the SSR-induced group was (8.09 6 5.22) 3 103 (nmol/mg min) while that of the control group was (117.54 6 39.01) 3103 (nmol/mg min). These data suggest that catK activity of the SSR-induced skin was obviously decreased compared to the normal control skin (P \.001). Conclusions: Our data suggest that catK is related to photoaging, probably the process of solar elastosis. We propose that the decrease of catK activity might lead to a decline of elastin degradation and subsequent accumulation of elastin in the extracellular space. Commercial support: None identified.
P3111
Results: Complete remissions were achieved in 100% (4/4) of atrophic type, 43.75% (7/16) of hypertrophic type, 0% (0/10) of Bowenoid type in AK, and 40% (2/5) in BD. There was no significant difference of ALA-PDT response between BD and AK (P ¼.22). In AK, Bowenoid type was less effective than other subtypes (P ¼.0022). The response was the best in atrophic type of AK as compared with the other precancerous lesions of the skin (P ¼ .025). Conclusion: The responses to ALA-PDT were different in the histopathologic subtypes of precancerous diseases.
Facial rejuvenation using novel topical aminolevulinic acid ester Anne Chapas, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Elliot Weiss, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Lori Brightman, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Patricia Pao, MBA, Pao Principle, New York, NY, United States; Roy G. Geronemus, MD, Laser and Skin Surgery Center of New York, New York, NY, United States Background: Although photodynamic therapy (PDT) using topical application of aminolevulinic acid (ALA) derivatives before activation by various light and lasers can improve the appearance of photodamaged skin, the amount of phototoxicity associated with these treatments has limited their widespread use in cosmetic applications. A novel ALA derivative, low concentration ALA ester, has been developed to deliver the beneficial cosmetic effects of PDT without the unwanted side effects. The purpose of this study is to evaluate the effectiveness and safety of application of ALA ester followed by red light exposure to improve the appearance of photodamaged skin. Methods: A prospective trial was performed with 16 subjects receiving three monthly treatments of topical ALA ester to the entire face followed by exposure to red light (635 nm, 37 J/cm2) 1 hour later. Objective measurements including corneometer measurement of hydration, chromameter measurement of skin color, PRIMOS imaging of fine lines and ballistometer and cutometer measurement of firmness and elasticity were performed before each treatment and 1 month after the last treatment. High scope measurement of pore size was performed before and after the first treatment. Erythema and edema were evaluated on a 4-point scale immediately and 48 hours after treatment. Subjective measures included evaluation of pretreatment and 1 month posttreatment standardized clinical photographs by three blinded dermatologists for improvement in photodamage and subject selfassessment questionnaires that were completed at every visit. Results: Treatments were well tolerated by the majority of the subjects. Ten subjects completed the study and six were lost to follow-up. Most subjects showed little to no erythema or edema immediately following the treatment and 48 hours later. Statistically significant improvement in skin color (9%-18%), pore size (16% reduction), and elasticity (42% improvement) was shown as early as the first treatment. PRIMOS imaging showed improvement in skin roughness of 11% and wrinkle depth of 7%, 1 month after the last treatment. Physician evaluation of photographs and subject self-assessments reflected the degree of improvements seen in objectives measurements. Conclusions: Topical ALA ester followed by exposure red light improves multiple aspects of photodamaged skin as measured by objective and subjective criteria with minimal side effects.
Commercial support: None identified.
Commercial support: 100% sponsored by Photocure ASA, Olso, Norway.
P3109 The responses to photodynamic therapy in histopathologic subtypes of precancerous disesases Jai Kyoung Koh, MD, PhD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Deborah Lee, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Hyun Soo Sim, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Ji Sung Chun, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Soon Kwon Hong, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea Background: Precancerous diseases of the skin such as actinic keratosis (AK) and Bowen disease (BD) were treated with local liquid nitrogen cryotherpy, topical fluorouracil, or laser surgery. Recently, these diseases are treated successfully with photodynamic therapy (PDT). But there have been no studies on the response to PDT in the histopathologic subtypes of precancerous diseases. Objective: We evaluated the responses to PDT using topical 20% aminolevulinic acid (ALA) solution and blue light in the histopathologic subtypes of the precancerous diseases. Methods: Thirty AK lesions of 21 patients and five BD lesions of four patients were enrolled in the study. The 30 AK lesions were divided into three groups as atrophic type, hypertrophic type, and Bowenoid type. The lesions were incubated with topical 20% ALA solution for 2 hours and exposured to blue light (417 6 5 nm) with 10 J/cm2. The lesions were assessed at 48 hours and 2 and 4 weeks after PDT. At 4 weeks, the lesions remaining clinically were retreated. The evaluations of response to ALA-PDT were performed by skin biopsies at 8 weeks.
AB140
J AM ACAD DERMATOL
FEBRUARY 2011
P3110
Change of cathepsin K activity in human skin in vivo after chronic ultraviolet damage Zhangzhang Ye, MD, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Wei Lai, MD, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Sunscreen use and sun exposure in a population of Japanese females Akira Kawada, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Kana Ishihara, Professional Product Planning Division, Marketing Department, Rohto Pharmaceutical, Tokyo, Japan; Naoki Oiso, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Shigeru Kawara, MD, PhD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan; Tomohiko Narita, MD, Kinki University Faculty of Medicine, Osaka-Sayama City, Japan
Objective: Photoaging is histologically characterized by the accumulation of abnormal elastin-containing material and disorganization of decreased bundles of collagen fibers. The fundamental mechanisms are still poorly understood. So far, most of the photoaging studies are focused on matrix metalloproteinases (MMPs). It was described that cathepsin K (catK) might play an important role in mediating intracellular elastin degradation.We hypothesize that catK may be related to ECM homeostasis in photoaging. We therefore studied the activity of catK in human skin in response to chronic SSR. Methods: Eight healthy Chinese volunteers (4 males and 4 females) were enrolled in the study after signing an informed consent that was approved by the medical ethics committee in our hospital ([2009]2-2). They were 21 to 26 years old with Fitzpatrick skin phototypes III or IV. The untanned upper buttock region was used as the site for exposure. The random side of upper buttock region was exposed to 1 MED of SSR (spectrum of 290-400 nm, 30% UVA + 70% UVB) per exposure every day for 5 successive days/week for 6 weeks. The other side of the upper buttock received no irradiation as control.The specific cathepsin K substrate, z-Leu-Arg-7-amido-4-methyl coumarin, was used. The fluorescence which the cleavage product emitted was recorded at 360 nm. The activity of catK was determined by the intensity of the fluorescence. All measurements were done in triplicate. Statistical significance was determined by using the paired samples t test. Calculations were performed using SPSS 17.0. Statistical significance was set at P \.05.
Chronic exposure to sunlight causes photoaging. Sunscreens are used to prevent the skin from photoaging and acute sun damage. To elucidate the relationship between photoaging and sun exposure, we investigated photoaging signs, sun exposure history, and sunscreen use in 514 Japanese females using an online interview on October 19 and 20, 2009. The largest number of subjects belonged to Japanese skin type (JST) class J-II (53%), J-I was second (31%), and J-III was third (16%). Fifty-seven and 45% had worrisome fleckles and wrinkles, respectively. A group with much and moderate sun exposure significantly had worrisome fleckles more than a group with minimum and little sun exposure (P \ .01). Frequency of sun exposure had no significant relation to presence of worrisome wrinkles. Eighty-seven percent knew sun protection factor (SPF), but 86% of them had not accurate understanding the definition of SPF. Seventy-four percent knew protection grade of UVA (PA), but 91% of them did not understand the definition of PA. This study showed that a relationship between fleckles and sun exposure history and insufficient knowledge of SPF and PA in a population of Japanese females. Commercial support: None identified.
Results: Chronic SSR exposure for 6 weeks induced a significant clinical and histologic change of chronic photodamage. The result showed that the average activity of the SSR-induced group was (8.09 6 5.22) 3 103 (nmol/mg min) while that of the control group was (117.54 6 39.01) 3103 (nmol/mg min). These data suggest that catK activity of the SSR-induced skin was obviously decreased compared to the normal control skin (P \.001). Conclusions: Our data suggest that catK is related to photoaging, probably the process of solar elastosis. We propose that the decrease of catK activity might lead to a decline of elastin degradation and subsequent accumulation of elastin in the extracellular space. Commercial support: None identified.
P3111
Results: Complete remissions were achieved in 100% (4/4) of atrophic type, 43.75% (7/16) of hypertrophic type, 0% (0/10) of Bowenoid type in AK, and 40% (2/5) in BD. There was no significant difference of ALA-PDT response between BD and AK (P ¼.22). In AK, Bowenoid type was less effective than other subtypes (P ¼.0022). The response was the best in atrophic type of AK as compared with the other precancerous lesions of the skin (P ¼ .025). Conclusion: The responses to ALA-PDT were different in the histopathologic subtypes of precancerous diseases.
Facial rejuvenation using novel topical aminolevulinic acid ester Anne Chapas, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Elliot Weiss, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Lori Brightman, MD, Laser and Skin Surgery Center of New York, New York, NY, United States; Patricia Pao, MBA, Pao Principle, New York, NY, United States; Roy G. Geronemus, MD, Laser and Skin Surgery Center of New York, New York, NY, United States Background: Although photodynamic therapy (PDT) using topical application of aminolevulinic acid (ALA) derivatives before activation by various light and lasers can improve the appearance of photodamaged skin, the amount of phototoxicity associated with these treatments has limited their widespread use in cosmetic applications. A novel ALA derivative, low concentration ALA ester, has been developed to deliver the beneficial cosmetic effects of PDT without the unwanted side effects. The purpose of this study is to evaluate the effectiveness and safety of application of ALA ester followed by red light exposure to improve the appearance of photodamaged skin. Methods: A prospective trial was performed with 16 subjects receiving three monthly treatments of topical ALA ester to the entire face followed by exposure to red light (635 nm, 37 J/cm2) 1 hour later. Objective measurements including corneometer measurement of hydration, chromameter measurement of skin color, PRIMOS imaging of fine lines and ballistometer and cutometer measurement of firmness and elasticity were performed before each treatment and 1 month after the last treatment. High scope measurement of pore size was performed before and after the first treatment. Erythema and edema were evaluated on a 4-point scale immediately and 48 hours after treatment. Subjective measures included evaluation of pretreatment and 1 month posttreatment standardized clinical photographs by three blinded dermatologists for improvement in photodamage and subject selfassessment questionnaires that were completed at every visit. Results: Treatments were well tolerated by the majority of the subjects. Ten subjects completed the study and six were lost to follow-up. Most subjects showed little to no erythema or edema immediately following the treatment and 48 hours later. Statistically significant improvement in skin color (9%-18%), pore size (16% reduction), and elasticity (42% improvement) was shown as early as the first treatment. PRIMOS imaging showed improvement in skin roughness of 11% and wrinkle depth of 7%, 1 month after the last treatment. Physician evaluation of photographs and subject self-assessments reflected the degree of improvements seen in objectives measurements. Conclusions: Topical ALA ester followed by exposure red light improves multiple aspects of photodamaged skin as measured by objective and subjective criteria with minimal side effects.
Commercial support: None identified.
Commercial support: 100% sponsored by Photocure ASA, Olso, Norway.
P3109 The responses to photodynamic therapy in histopathologic subtypes of precancerous disesases Jai Kyoung Koh, MD, PhD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Deborah Lee, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Hyun Soo Sim, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Ji Sung Chun, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea; Soon Kwon Hong, MD, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea Background: Precancerous diseases of the skin such as actinic keratosis (AK) and Bowen disease (BD) were treated with local liquid nitrogen cryotherpy, topical fluorouracil, or laser surgery. Recently, these diseases are treated successfully with photodynamic therapy (PDT). But there have been no studies on the response to PDT in the histopathologic subtypes of precancerous diseases. Objective: We evaluated the responses to PDT using topical 20% aminolevulinic acid (ALA) solution and blue light in the histopathologic subtypes of the precancerous diseases. Methods: Thirty AK lesions of 21 patients and five BD lesions of four patients were enrolled in the study. The 30 AK lesions were divided into three groups as atrophic type, hypertrophic type, and Bowenoid type. The lesions were incubated with topical 20% ALA solution for 2 hours and exposured to blue light (417 6 5 nm) with 10 J/cm2. The lesions were assessed at 48 hours and 2 and 4 weeks after PDT. At 4 weeks, the lesions remaining clinically were retreated. The evaluations of response to ALA-PDT were performed by skin biopsies at 8 weeks.
AB140
J AM ACAD DERMATOL
FEBRUARY 2011