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Efficacy of photodynamic therapy associated to pretreatment with AHA peel in facial diffuse photodamage
Comparison of MED testing using a handheld semiautomated device and the conventional panel method
Effect of an antioxidant combination on infrared-a induced MMP1upregulation in human dermal fibroblasts
(Poster reference number 5313)
(Poster reference number 5723)
Maeve Lynch, MBBCh, St. Vincent’s University Hospital, Dublin, Ireland; Jackie McCavana, St. Vincent’s University Hospital, Dublin, Ireland; Linda Gray, St. Vincent’s University Hospital, Dublin, Ireland; Paul Collins, MBBCh, St. Vincent’s University Hospital, Dublin, Ireland The handheld semiautomated device is more convenient compared to the conventional method of minimal erythema dose (MED) testing. The aim of this study was to compare MED testing using the handheld device with the conventional TL-01 panel method in our unit using the same test doses. Twenty-four patients referred for phototherapy were recruited. Phototesting was performed on the back using Waldmann UV801BL with TL-01 fluorescent tubes and UV opaque template and handheld MED TL-01 tester (Hybec Ltd). Ten doses increasing by 26% were given. The MED was read 24 hours later by a consultant dermatologist, a registrar and two phototherapy nurses. Irradiance was measured weekly using a calibrated IL1400A radiometer and SEL005/TLS312/TD detector for the TL-01 panel and T1 input optic for the handheld device. The linear regression model shows that the TL-01 panel MED is a significant estimator of the MED for the handheld device (r ¼ 0.672; P (slope) ¼ .001). The MED readings for the conventional method were consistently higher. The average ratio of the handheld MED to the conventional MED was 67%. A BlandeAltman plot of the difference between the mean MEDs was 165 mJ/cm2. The MED using the handheld device could mean 3 more treatments to reach the conventional method starting dose. This was greater than the mean difference of 48.5 mJ/cm2 reported by Otman. The interobserver test showed very high agreement for both methods with a Crombach alfa coefficient of 0.976 for the handheld device vs 0.937 for the conventional method. Patients were subsequently treated with a starting dose of 70% of the MED determined by the conventional method. No patient developed significant erythema during the treatment course demonstrating that the higher MED results with the conventional method were safe and accurate. This study confirms that using the handheld semiautomated device to define the MED is valid and easier to perform compared with the conventional method of MED testing but is less accurate.
Christian Oresajo, L’Oreal Research and Innovation, Clark, NJ, United States; Jean Krutmann, IUF, Dusseldorf, Germany; Margarita Yatskayer, L’Oreal Research and Innovation, Clark, NJ, United States; Susanne Grether-Beck, IUF, D€ usseldorf, Germany Background: Previous studies suggest that human skin is a target for infrared A radiation (IRA). We have shown that antioxidants can decrease IRA-induced upregulation of MMP-1, the main collagen degrading enzyme in human skin. The purpose of this study was to determine if a combination of ascorbic acid, tocopherol and ferulic acid can prevent IRA-induced damage in human dermal fibroblast when compared to placebo. Methods: Human dermal fibroblasts, HDFs, in 6 well plates were grown for 4 days in culture. Cells were starved for 24 hours before irradiation and treated with the antioxidant mixture or placebo. The cells were then exposed to a dose of 360 J/cm2 IRA using a Hydrosun 500H IRA device (Hydrosun Medizintechnik GmbH, M€ ullheim, Germany). The culture dishes were cooled using a thermostatic bath during the exposure to maintain temperatures at 378C during irradiation. Control cells were held on a 378C thermostated plate under similar conditions without irradiation. During irradiation, cells were maintained in PBS. After irradiation, antioxidant mixture or placebo was added to the cells in fresh media containing 2 % FCS and incubated until harvest of cells 24 h post IRA treatment. 3 different dilutions were tested for both antioxidant mixture and placebo. At the end of the 24-hour period, total RNA was isolated from the cells for Rt-PCR analysis of MMP-1. Results: Our results demonstrate that IRA (360 J/cm2) radiation resulted in a 2.6-fold increase of MMP-1 in control cultures. Both antioxidant mixture and placebo reduced IRA-induced MMP-1 expression, however, to different degrees. The antioxidant mixture containing the combination of ascorbic acid, tocopherol, and ferulic acid was significantly more protective than placebo. Commercial support: 100% sponsored by L’Oreal.
Commercial support: None identified.
Efficacy of photodynamic therapy associated to pretreatment with AHA peel in facial diffuse photodamage Design and testing of a physical sunscreen for use on sensitive skin
(Poster reference number 5288)
Hao Ouyang, PhD, Neutrogena Corporation, Los Angeles, CA, United States; Thomas Stephens, PhD, Thomas Stephens and Associates, Carollton, TX, United States; Yohini Appa, PhD, Neutrogena Corp, Los Angeles, CA, United States Dermatologists recognize that their patients with sensitive skin need effective sun protection that is also gentle to their skin. Titanium dioxide and zinc oxide have been shown to provide balanced UVA and UVB protection that is photostable, while also being very mild to skin. These sunscreen filters do not penetrate into normal skin and they are chemically inert. In addition to these sunscreen actives, other ingredients in the formulation, such as fragrances, dyes, preservatives, abrasives and volatiles, may also cause tolerance issues for patients with sensitive skin. This work demonstrates the design and development of a mineral sunscreen formulation that is formulated specifically for sensitive skin patients. . This formulation was evaluated in several clinical tests to demonstrate that it is suitable for patients with sensitive skin. Included in the battery of tests was clinical irritation which was evaluated on the backs of 25 subjects with normal skin every day during the 12 days of repeated patches (1 patch a day). The cumulative irritation score showed no irritant contact dermatitis and visible erythema was nearly absent. A second cumulative irritation patch test was conducted on a separate panel of 28 subjects with self-described sensitive skin. No visible erythema was observed for any of these subjects and the formulation was determined to be mild, based on the criteria used by Berger and Bowman. The tolerability of the sunscreen in use was assessed in a controlled clinical study, in which 25 sensitive skin patients were recruited to use the formulation at least once daily for 2 weeks on their bodies. All 25 patients were clinically determined to have atopic conditions based on features established by Hanifin and Rajka. Their skin was clinically evaluated as baseline, week 1 and week 2. No clinical irritation (erythema, itch, stinging) was found with the use of the formulation. In addition, improvements were seen in the dryness and scaling that can often be associated with the skin of these patients. These results provide practicing dermatologists with valuable information that can benefit their sensitive skin patients, who are searching for the most appropriate sun care products. Commercial support: None identified.
APRIL 2012
(Poster reference number 5628)
Blanca Moyano Almagro, Department of Dermatology, Virgen de la Victoria University Hospital, Malaga, Spain; Enrique Herrera-Acosta, Department of Dermatology, Malaga, Spain; Enrique Herrera-Ceballos, Department of Dermatology, Malaga, Spain; Maria Victoria Mendiola-Fernandez, Department of Dermatology, Malaga, Spain; Norberto L opez-Navarro, Department of Dermatology, Malaga, Spain; Ricardo Bosch-Garcıa, Department of Dermatology, Malaga, Spain; Teresa Meyer-Gonzalez, Department of Dermatology, Malaga, Spain Introduction: To date, there is no criterion standard therapy for skin photoaging. Resurfacing modalities have their own benefits and drawbacks. More recently, openlabel studies and few controlled trials have suggested that photodynamic therapy (PDT) may have therapeutic potential in photodamage. Objective: To assess the efficacy and safety of methyl aminolevulinate (MAL) + PDT in patients with facial diffuse photodamage. And also to evaluate if pretreatment with alpha hydroxy acid (AHA) peel 1 week before can improve outcomes and reduce the incubation time during the therapeutic process. Methods: Fifteen patients with moderate to severe facial diffuse photodamage were included in this randomized, prospective, single blind study. Patients were randomized in one of the three therapeutic groups and random skin biopsies were performed. Five patients were treated with MAL 3 hours incubation + PDT in one hemifacial side and repeated in the other side with a 2-week interval. In 10 patients we applied an AHA peel one week before treatment with MAL-PDT. Of these 10 patients, 5 completed incubation time with MAL during three hours and the other 5 patients had an incubation time with MAL just for1 hour. Treatment with PDT in one hemifacial side and in the other hemifacial side 2 weeks later was completed in the 10 patients. Conclusion: The results obtained showed that field therapy with MAL-PDT confers a significant efficacy in global facial photodamage including reductions in keratinocyte atypia, hyperkeratosis, parakeratosis, and inflammation. Furthermore, pretreatment with AHA also demonstrated an improvement in the final results. Commercial support: None identified.
J AM ACAD DERMATOL
AB175
Effect of an antioxidant combination on infrared-a induced MMP1upregulation in human dermal fibroblasts
(Poster reference number 5313)
(Poster reference number 5723)
Maeve Lynch, MBBCh, St. Vincent’s University Hospital, Dublin, Ireland; Jackie McCavana, St. Vincent’s University Hospital, Dublin, Ireland; Linda Gray, St. Vincent’s University Hospital, Dublin, Ireland; Paul Collins, MBBCh, St. Vincent’s University Hospital, Dublin, Ireland The handheld semiautomated device is more convenient compared to the conventional method of minimal erythema dose (MED) testing. The aim of this study was to compare MED testing using the handheld device with the conventional TL-01 panel method in our unit using the same test doses. Twenty-four patients referred for phototherapy were recruited. Phototesting was performed on the back using Waldmann UV801BL with TL-01 fluorescent tubes and UV opaque template and handheld MED TL-01 tester (Hybec Ltd). Ten doses increasing by 26% were given. The MED was read 24 hours later by a consultant dermatologist, a registrar and two phototherapy nurses. Irradiance was measured weekly using a calibrated IL1400A radiometer and SEL005/TLS312/TD detector for the TL-01 panel and T1 input optic for the handheld device. The linear regression model shows that the TL-01 panel MED is a significant estimator of the MED for the handheld device (r ¼ 0.672; P (slope) ¼ .001). The MED readings for the conventional method were consistently higher. The average ratio of the handheld MED to the conventional MED was 67%. A BlandeAltman plot of the difference between the mean MEDs was 165 mJ/cm2. The MED using the handheld device could mean 3 more treatments to reach the conventional method starting dose. This was greater than the mean difference of 48.5 mJ/cm2 reported by Otman. The interobserver test showed very high agreement for both methods with a Crombach alfa coefficient of 0.976 for the handheld device vs 0.937 for the conventional method. Patients were subsequently treated with a starting dose of 70% of the MED determined by the conventional method. No patient developed significant erythema during the treatment course demonstrating that the higher MED results with the conventional method were safe and accurate. This study confirms that using the handheld semiautomated device to define the MED is valid and easier to perform compared with the conventional method of MED testing but is less accurate.
Christian Oresajo, L’Oreal Research and Innovation, Clark, NJ, United States; Jean Krutmann, IUF, Dusseldorf, Germany; Margarita Yatskayer, L’Oreal Research and Innovation, Clark, NJ, United States; Susanne Grether-Beck, IUF, D€ usseldorf, Germany Background: Previous studies suggest that human skin is a target for infrared A radiation (IRA). We have shown that antioxidants can decrease IRA-induced upregulation of MMP-1, the main collagen degrading enzyme in human skin. The purpose of this study was to determine if a combination of ascorbic acid, tocopherol and ferulic acid can prevent IRA-induced damage in human dermal fibroblast when compared to placebo. Methods: Human dermal fibroblasts, HDFs, in 6 well plates were grown for 4 days in culture. Cells were starved for 24 hours before irradiation and treated with the antioxidant mixture or placebo. The cells were then exposed to a dose of 360 J/cm2 IRA using a Hydrosun 500H IRA device (Hydrosun Medizintechnik GmbH, M€ ullheim, Germany). The culture dishes were cooled using a thermostatic bath during the exposure to maintain temperatures at 378C during irradiation. Control cells were held on a 378C thermostated plate under similar conditions without irradiation. During irradiation, cells were maintained in PBS. After irradiation, antioxidant mixture or placebo was added to the cells in fresh media containing 2 % FCS and incubated until harvest of cells 24 h post IRA treatment. 3 different dilutions were tested for both antioxidant mixture and placebo. At the end of the 24-hour period, total RNA was isolated from the cells for Rt-PCR analysis of MMP-1. Results: Our results demonstrate that IRA (360 J/cm2) radiation resulted in a 2.6-fold increase of MMP-1 in control cultures. Both antioxidant mixture and placebo reduced IRA-induced MMP-1 expression, however, to different degrees. The antioxidant mixture containing the combination of ascorbic acid, tocopherol, and ferulic acid was significantly more protective than placebo. Commercial support: 100% sponsored by L’Oreal.
Commercial support: None identified.
Efficacy of photodynamic therapy associated to pretreatment with AHA peel in facial diffuse photodamage Design and testing of a physical sunscreen for use on sensitive skin
(Poster reference number 5288)
Hao Ouyang, PhD, Neutrogena Corporation, Los Angeles, CA, United States; Thomas Stephens, PhD, Thomas Stephens and Associates, Carollton, TX, United States; Yohini Appa, PhD, Neutrogena Corp, Los Angeles, CA, United States Dermatologists recognize that their patients with sensitive skin need effective sun protection that is also gentle to their skin. Titanium dioxide and zinc oxide have been shown to provide balanced UVA and UVB protection that is photostable, while also being very mild to skin. These sunscreen filters do not penetrate into normal skin and they are chemically inert. In addition to these sunscreen actives, other ingredients in the formulation, such as fragrances, dyes, preservatives, abrasives and volatiles, may also cause tolerance issues for patients with sensitive skin. This work demonstrates the design and development of a mineral sunscreen formulation that is formulated specifically for sensitive skin patients. . This formulation was evaluated in several clinical tests to demonstrate that it is suitable for patients with sensitive skin. Included in the battery of tests was clinical irritation which was evaluated on the backs of 25 subjects with normal skin every day during the 12 days of repeated patches (1 patch a day). The cumulative irritation score showed no irritant contact dermatitis and visible erythema was nearly absent. A second cumulative irritation patch test was conducted on a separate panel of 28 subjects with self-described sensitive skin. No visible erythema was observed for any of these subjects and the formulation was determined to be mild, based on the criteria used by Berger and Bowman. The tolerability of the sunscreen in use was assessed in a controlled clinical study, in which 25 sensitive skin patients were recruited to use the formulation at least once daily for 2 weeks on their bodies. All 25 patients were clinically determined to have atopic conditions based on features established by Hanifin and Rajka. Their skin was clinically evaluated as baseline, week 1 and week 2. No clinical irritation (erythema, itch, stinging) was found with the use of the formulation. In addition, improvements were seen in the dryness and scaling that can often be associated with the skin of these patients. These results provide practicing dermatologists with valuable information that can benefit their sensitive skin patients, who are searching for the most appropriate sun care products. Commercial support: None identified.
APRIL 2012
(Poster reference number 5628)
Blanca Moyano Almagro, Department of Dermatology, Virgen de la Victoria University Hospital, Malaga, Spain; Enrique Herrera-Acosta, Department of Dermatology, Malaga, Spain; Enrique Herrera-Ceballos, Department of Dermatology, Malaga, Spain; Maria Victoria Mendiola-Fernandez, Department of Dermatology, Malaga, Spain; Norberto L opez-Navarro, Department of Dermatology, Malaga, Spain; Ricardo Bosch-Garcıa, Department of Dermatology, Malaga, Spain; Teresa Meyer-Gonzalez, Department of Dermatology, Malaga, Spain Introduction: To date, there is no criterion standard therapy for skin photoaging. Resurfacing modalities have their own benefits and drawbacks. More recently, openlabel studies and few controlled trials have suggested that photodynamic therapy (PDT) may have therapeutic potential in photodamage. Objective: To assess the efficacy and safety of methyl aminolevulinate (MAL) + PDT in patients with facial diffuse photodamage. And also to evaluate if pretreatment with alpha hydroxy acid (AHA) peel 1 week before can improve outcomes and reduce the incubation time during the therapeutic process. Methods: Fifteen patients with moderate to severe facial diffuse photodamage were included in this randomized, prospective, single blind study. Patients were randomized in one of the three therapeutic groups and random skin biopsies were performed. Five patients were treated with MAL 3 hours incubation + PDT in one hemifacial side and repeated in the other side with a 2-week interval. In 10 patients we applied an AHA peel one week before treatment with MAL-PDT. Of these 10 patients, 5 completed incubation time with MAL during three hours and the other 5 patients had an incubation time with MAL just for1 hour. Treatment with PDT in one hemifacial side and in the other hemifacial side 2 weeks later was completed in the 10 patients. Conclusion: The results obtained showed that field therapy with MAL-PDT confers a significant efficacy in global facial photodamage including reductions in keratinocyte atypia, hyperkeratosis, parakeratosis, and inflammation. Furthermore, pretreatment with AHA also demonstrated an improvement in the final results. Commercial support: None identified.
J AM ACAD DERMATOL
AB175