Photodynamic therapy for acne vulgaris: A critical review from basics to clinical practice Part I. Acne vulgaris: When and why consider photodynamic therapy?
Photodynamic therapy for acne vulgaris: A critical review from basics to clinical practice Part I. Acne vulgaris: When and why consider photodynamic therapy?
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DOI：
10.1016/j.jaad.2009.09.056
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发表时间：
2010-08-01
影响因子：
13.8
通讯作者：
Anderson, R. Rox
中科院分区：
文献类型：
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作者：
Sakamoto, Fernanda H.;Lopes, Jose Daniel;Anderson, R. Rox
治疗寻常痤疮的一线药物是传统的局部和/或口服药物。然而，许多患者有禁忌症，只有部分反应，严重的不良反应，或复发。光疗法和光动力疗法(PDT)是治疗寻常痤疮的非标记性替代疗法，各有优缺点。到目前为止，关于光动力疗法的方法和参数还没有达成共识。了解痤疮的病理生理学，光组织的相互作用，以及光动力疗法的作用机制，无论何时光动力疗法被认为是一种替代治疗方法，都是有帮助的。总体而言，蓝光单独可以改善痤疮，因为它有抗炎作用。使用5-氨基酮戊酸(ALA)或ALA衍生物的PDT可诱导一过性的抗菌和抗炎作用。在高剂量下，红光PDT可导致皮脂腺的抑制或破坏，从而导致临床改善。(J Am Acad Dermatol 2010；63：183-93。)
The first-line treatments for acne vulgaris are conventional topical and/or oral medications. However, many patients have contraindications, only partial response, significant adverse effects, or recurrence. Light-based treatments and photodynamic therapy (PDT) using topical precursors of porphyrins are off-label alternative treatments for acne vulgaris, with their own advantages and disadvantages. To date, there is no consensus on PDT methodology and parameters. An understanding of pathophysiology of acne, light tissue interactions, and PDT mechanisms of action is helpful whenever PDT is considered as an alternative treatment. In general, blue light alone improves acne because of its antiinflammatory effects. PDT using 5-aminolevulenic acid (ALA) or ALA derivatives induces transient antimicrobial and antiinflammatory effects. At high doses, red light PDT may induce inhibition or destruction of sebaceous glands, resulting in clinical improvement. (J Am Acad Dermatol 2010;63:183-93.)