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Topical 5-aminolevulinic acid–based photodynamic therapy: A novel treatment for refractory Flegel's disease
P2411
P2413
Photoprotection effect of different topical antioxidants on ultraviolet Aeinduced erythema and pigmentation Christian Oresajo, PhD, L’Oreal Recherche, Clark, NJ, United States; Dominique Moyal, PhD, L’Oreal Recherche, Asnieres-sur-Seine Cedex, France; Isabelle Hansenne, PhD, L’Oreal Recherche, Clark, NJ, United States; Hani Fares, PhD, L’Oreal Recherche, Clark, NJ, United States
Evaluation of sunburn protection by a single application of an SPF 70 formulation at high altitudes under extreme sun conditions Darrell Rigel, MD, NYU Medical Center, New York, NY, United States; Theresa Chen, PhD, Neutrogena Corporation, Los Angeles, CA, United States; Yohini Appa, PhD, Neutrogena Corporation, Los Angeles, CA, United States
Some of the major changes taking place in the skin as part of the aging process are caused by environmental factors, particularly solar exposure. Chronic exposure to sunlight causes the generation of oxidative stress in the skin, resulting in impaired mechanical and biophysical properties of the skin. Antioxidants have been shown to reduce the negative effects of UV damage by counteracting the generation of oxidative stress in the skin. The use of phloretin in combination with other antioxidants may provide optimal photoprotection. The objective of this study was to compare the photoprotection effect of phloretin alone, vitamin C alone, phloretin 1 ferulic acid, phloretin 1 ferulic acid 1 vitamin C, ferulic acid 1 vitamin C 1 vitamin E, and the vehicle. Ten volunteers with very light to light skin (phototype II) completed the study. Each of the 6 compositions was applied at the rate of 4 mg/cm2 on the back of the volunteers using finger cot. One hour and thirty minutes after application, the treated zones were exposed to UVA under the spectra 320 to 440 nm at a dosage of 2 MiED (minimal individual erythema dose, already established on the same subjects). Colorimetric measurements and visual determinations were made 2 hours after exposure to evaluate the intensity of the UVA erythema. The mixture erythema 1 pigmentation (PPD) was evaluated by colorimeter. The results demonstrated that the mixture of phloretin, ferulic acid, and vitamin C was the most efficacious when compared to other combinations tested on UVA induced erythema and mixture of erythema 1 pigmentation (PPD).
Risk of sunburn and long-term sun damage is exaggerated at high altitudes as a result of decreased ozone filtration. Sunscreens can provide effective protection if they contain adequate and photostable UV filter systems, and are applied appropriately. However, consumers often underapply and do not reapply their sunscreens. This study was aimed at evaluating the protective effect of a single application of a new SPF70 formulation containing a patented photostable sunscreen system against sunburn while skiing under the extreme sun exposure conditions at high altitudes. The protective effect was evaluated on 75 subjects during a whole day of skiing in December at Vail, CO (elevation 8500 ft). UVB and UVA irradiation from the sun were measured with a radiometer at 1-hour intervals. Participants applied the sunscreens in the morning before skiing and returned on the next morning for skin evaluation by a dermatologist, photography, and self-assessment via questionnaire. Dermatologist grading results showed that although subjects skied an average of 5.3 hours, no sunburn was observed on 70 out of 71 subjects who completed the study. One subject showed slight erythema on the nose where she admitted to have underapplied. Subjects did not report any significant windburn or chapping, and felt that their skin was well moisturized. These results indicate that a single application of the new SPF70 formulation containing the patented photostable sunscreen system effectively protected against sunburn during over five hours of skiing at high altitudes. 100% sponsored by Neutrogena Corporation.
100% sponsored by L’Oreal.
P2412 Split-face study of facial rejuvenation for fine-line wrinkles using pulsed dye laser with or without topical application of aminolevulinic acid Christopher Hunzeker, MD, NYU Department of Dermatology, New York, NY, United States; Anne Chapas, MD, Laser & Skin Surgery Center of New York, New York, NY, United States; Sean Sukal, MD, PhD, Laser & Skin Surgery Center of New York, New York, NY, United States; Roy Geronemus, MD, Laser & Skin Surgery Center of New York, New York, NY, United States Purpose: Topical application of aminolevulinic acid (ALA) activated by intense pulsed light or blue light has been shown to improve fine-line facial wrinkles. Likewise, the pulsed dye laser (PDL) has been shown to improve facial rhytides. PDL effectively activates ALA. The purpose of our study is to determine whether combination therapy with topical ALA application followed by treatment with PDL ameliorates fine-line wrinkles better than PDL treatment alone.
P2414
Results: Treatments were well tolerated by all subjects. At 32 weeks, patients demonstrated 45% to 67% improvements in facial tactile roughness, hyperpigmentation, and erythema. Blinded assessment of fine-line wrinkles noted improvement in all patients treated with topical ALA. Patients treated with the combination of ALA plus PDL showed 35% greater improvement in fine-line wrinkles than was seen in patients treated with PDL alone. Conclusion: Topical ALA activated by PDL is a safe, nonablative method of facial rejuvenation as measured by above objective criteria.
Topical 5-aminolevulinic acidebased photodynamic therapy: A novel treatment for refractory Flegel’s disease Sima Torabian, MD, University of California, Davis, Sacramento, CA, United States; Maxwell Fung, MD, University of California, Davis, Sacramento, CA, United States; Daniel Eisen, MD, University of California, Davis, Sacramento, CA, United States Hyperkeratosis lenticularis perstans (Flegel’s disease) is a rare disorder characterized by asymptomatic hyperkeratotic papules that are usually distributed on the extremities. It typically develops in the fourth to fifth decade of life and has been reported to be transmitted in an autosomal dominant pattern, although sporadic cases may occur. Management of this disease has been difficult; many treatments such as emollients, cryotherapy, PUVA, topical retinoids, calcipotriol and 5-fluorouracil have been tried with variable success. We present a 63-year-old female with Flegel’s disease on her lower extremities whose long standing lesions have been refractory to cryotherapy, topical 5-fluorouracil and imiquimod. She has been undergoing photodynamic therapy with topical 5-aminolevulinic acid (ALA) activated by blue light (417 nm). After 4 treatments, she has noted an 80% to 90% improvement in appearance and texture of her skin with many resistant lesions resolving. The only reported side effect has been mild erythema with each treatment. This is the first reported case of Flegel’s disease treated with topical 5aminolevulinic acidebased photodynamic therapy and our preliminary results show that this modality may be a viable treatment option for refractory cases of Flegel’s disease.
Commercial support: None identified.
Commercial support: None identified.
Design: A double-blind, split-face trial was performed with fourteen patients receiving three monthly treatments with PDL to the entire face following the application of topical ALA to half of the subject’s face and a 1-hour incubation period. Patients were evaluated at each treatment visit and at 4- and 12-week visits and 6-month follow-up visits with scoring of periocular wrinkling, tactile roughness, mottled hyperpigmentation, and erythema. Standardized clinical photographs were taken at every visit. The screening and 32-week photographs were assessed by three blinded physician evaluators. Objective measurements included PRIMOS imaging of facial wrinkles and BTC-2000 measurements of skin tone and elasticity. Biopsy specimens were requested of each subject at the screening and six-month visits.
FEBRUARY 2008
J AM ACAD DERMATOL
AB113
P2413
Photoprotection effect of different topical antioxidants on ultraviolet Aeinduced erythema and pigmentation Christian Oresajo, PhD, L’Oreal Recherche, Clark, NJ, United States; Dominique Moyal, PhD, L’Oreal Recherche, Asnieres-sur-Seine Cedex, France; Isabelle Hansenne, PhD, L’Oreal Recherche, Clark, NJ, United States; Hani Fares, PhD, L’Oreal Recherche, Clark, NJ, United States
Evaluation of sunburn protection by a single application of an SPF 70 formulation at high altitudes under extreme sun conditions Darrell Rigel, MD, NYU Medical Center, New York, NY, United States; Theresa Chen, PhD, Neutrogena Corporation, Los Angeles, CA, United States; Yohini Appa, PhD, Neutrogena Corporation, Los Angeles, CA, United States
Some of the major changes taking place in the skin as part of the aging process are caused by environmental factors, particularly solar exposure. Chronic exposure to sunlight causes the generation of oxidative stress in the skin, resulting in impaired mechanical and biophysical properties of the skin. Antioxidants have been shown to reduce the negative effects of UV damage by counteracting the generation of oxidative stress in the skin. The use of phloretin in combination with other antioxidants may provide optimal photoprotection. The objective of this study was to compare the photoprotection effect of phloretin alone, vitamin C alone, phloretin 1 ferulic acid, phloretin 1 ferulic acid 1 vitamin C, ferulic acid 1 vitamin C 1 vitamin E, and the vehicle. Ten volunteers with very light to light skin (phototype II) completed the study. Each of the 6 compositions was applied at the rate of 4 mg/cm2 on the back of the volunteers using finger cot. One hour and thirty minutes after application, the treated zones were exposed to UVA under the spectra 320 to 440 nm at a dosage of 2 MiED (minimal individual erythema dose, already established on the same subjects). Colorimetric measurements and visual determinations were made 2 hours after exposure to evaluate the intensity of the UVA erythema. The mixture erythema 1 pigmentation (PPD) was evaluated by colorimeter. The results demonstrated that the mixture of phloretin, ferulic acid, and vitamin C was the most efficacious when compared to other combinations tested on UVA induced erythema and mixture of erythema 1 pigmentation (PPD).
Risk of sunburn and long-term sun damage is exaggerated at high altitudes as a result of decreased ozone filtration. Sunscreens can provide effective protection if they contain adequate and photostable UV filter systems, and are applied appropriately. However, consumers often underapply and do not reapply their sunscreens. This study was aimed at evaluating the protective effect of a single application of a new SPF70 formulation containing a patented photostable sunscreen system against sunburn while skiing under the extreme sun exposure conditions at high altitudes. The protective effect was evaluated on 75 subjects during a whole day of skiing in December at Vail, CO (elevation 8500 ft). UVB and UVA irradiation from the sun were measured with a radiometer at 1-hour intervals. Participants applied the sunscreens in the morning before skiing and returned on the next morning for skin evaluation by a dermatologist, photography, and self-assessment via questionnaire. Dermatologist grading results showed that although subjects skied an average of 5.3 hours, no sunburn was observed on 70 out of 71 subjects who completed the study. One subject showed slight erythema on the nose where she admitted to have underapplied. Subjects did not report any significant windburn or chapping, and felt that their skin was well moisturized. These results indicate that a single application of the new SPF70 formulation containing the patented photostable sunscreen system effectively protected against sunburn during over five hours of skiing at high altitudes. 100% sponsored by Neutrogena Corporation.
100% sponsored by L’Oreal.
P2412 Split-face study of facial rejuvenation for fine-line wrinkles using pulsed dye laser with or without topical application of aminolevulinic acid Christopher Hunzeker, MD, NYU Department of Dermatology, New York, NY, United States; Anne Chapas, MD, Laser & Skin Surgery Center of New York, New York, NY, United States; Sean Sukal, MD, PhD, Laser & Skin Surgery Center of New York, New York, NY, United States; Roy Geronemus, MD, Laser & Skin Surgery Center of New York, New York, NY, United States Purpose: Topical application of aminolevulinic acid (ALA) activated by intense pulsed light or blue light has been shown to improve fine-line facial wrinkles. Likewise, the pulsed dye laser (PDL) has been shown to improve facial rhytides. PDL effectively activates ALA. The purpose of our study is to determine whether combination therapy with topical ALA application followed by treatment with PDL ameliorates fine-line wrinkles better than PDL treatment alone.
P2414
Results: Treatments were well tolerated by all subjects. At 32 weeks, patients demonstrated 45% to 67% improvements in facial tactile roughness, hyperpigmentation, and erythema. Blinded assessment of fine-line wrinkles noted improvement in all patients treated with topical ALA. Patients treated with the combination of ALA plus PDL showed 35% greater improvement in fine-line wrinkles than was seen in patients treated with PDL alone. Conclusion: Topical ALA activated by PDL is a safe, nonablative method of facial rejuvenation as measured by above objective criteria.
Topical 5-aminolevulinic acidebased photodynamic therapy: A novel treatment for refractory Flegel’s disease Sima Torabian, MD, University of California, Davis, Sacramento, CA, United States; Maxwell Fung, MD, University of California, Davis, Sacramento, CA, United States; Daniel Eisen, MD, University of California, Davis, Sacramento, CA, United States Hyperkeratosis lenticularis perstans (Flegel’s disease) is a rare disorder characterized by asymptomatic hyperkeratotic papules that are usually distributed on the extremities. It typically develops in the fourth to fifth decade of life and has been reported to be transmitted in an autosomal dominant pattern, although sporadic cases may occur. Management of this disease has been difficult; many treatments such as emollients, cryotherapy, PUVA, topical retinoids, calcipotriol and 5-fluorouracil have been tried with variable success. We present a 63-year-old female with Flegel’s disease on her lower extremities whose long standing lesions have been refractory to cryotherapy, topical 5-fluorouracil and imiquimod. She has been undergoing photodynamic therapy with topical 5-aminolevulinic acid (ALA) activated by blue light (417 nm). After 4 treatments, she has noted an 80% to 90% improvement in appearance and texture of her skin with many resistant lesions resolving. The only reported side effect has been mild erythema with each treatment. This is the first reported case of Flegel’s disease treated with topical 5aminolevulinic acidebased photodynamic therapy and our preliminary results show that this modality may be a viable treatment option for refractory cases of Flegel’s disease.
Commercial support: None identified.
Commercial support: None identified.
Design: A double-blind, split-face trial was performed with fourteen patients receiving three monthly treatments with PDL to the entire face following the application of topical ALA to half of the subject’s face and a 1-hour incubation period. Patients were evaluated at each treatment visit and at 4- and 12-week visits and 6-month follow-up visits with scoring of periocular wrinkling, tactile roughness, mottled hyperpigmentation, and erythema. Standardized clinical photographs were taken at every visit. The screening and 32-week photographs were assessed by three blinded physician evaluators. Objective measurements included PRIMOS imaging of facial wrinkles and BTC-2000 measurements of skin tone and elasticity. Biopsy specimens were requested of each subject at the screening and six-month visits.
FEBRUARY 2008
J AM ACAD DERMATOL
AB113