Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

Zhang, Linglin; Wang, Peiru; Shi, Lei; Zhang, Guolong; Zhang, Yunfeng; Zhou, Zhongxia; Huang, Zheng; Wang, Hongwei; Wang, Xiuli

doi:10.1142/s1793545816400022

Cited by 12 publications

(3 citation statements)

References 15 publications

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“…Two studies, with a total of four participants, used 5% ALA with an incubation period of 4 h under occlusion 24,25 . The light source was set to 96–126 J/cm 2 .…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of photodynamic therapy for the treatment of hidradenitis suppurativa

Reshetylo

Narla

Bakker

et al. 2022

Photoderm Photoimm Photomed

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Objective: To perform a systematic review of available literature regarding the use of 5-aminolevulinic acid (ALA) and ALA derivative photodynamic therapy (PDT) in the treatment of hidradenitis suppurativa (HS) and provide recommendations on its use. Methods:A systematic review was performed of all published studies up to September 1, 2019 from nine databases, including PubMed, that evaluated PDT in the treatment of HS. For each study, quality of evidence and risk of bias was evaluated. Recommendations from the body of evidence were created based on Strength of Recommendation and Taxonomy (SORT) criteria.Results: Eighteen studies met inclusion criteria. The majority of studies had a high risk of bias. Blue light PDT with 20% ALA and red light PDT with 16% methyl aminolevulinate (MAL) demonstrated some benefit based on a small number of poor-quality studies with a high risk of bias (Grade C, level III evidence). The most promising results were for 1%-5% ALA with intralesional diode, with good to complete response in 78%-94% of anatomic sites treated (Grade B, level II evidence). Limitations:The majority of studies contained high levels of bias, with significant heterogeneity between studies. Conclusions are limited by small samples sizes, lack of randomized controlled trials, and differing protocols. Conclusion:Further studies are needed to determine the clinical efficacy of 20% ALA with blue light and MAL with red light. Intralesional diode PDT shows the most promise and warrants further investigation in larger, randomized controlled trials.

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“…Two studies, with a total of four participants, used 5% ALA with an incubation period of 4 h under occlusion 24,25 . The light source was set to 96–126 J/cm 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies, with a total of four participants, used 5% ALA with an incubation period of 4 h under occlusion. 24 , 25 The light source was set to 96–126 J/cm 2 . While one patient had resolution of skin lesions, the three others had a poor response with no change in clinical symptoms.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of photodynamic therapy for the treatment of hidradenitis suppurativa

Reshetylo

Narla

Bakker

et al. 2022

Photoderm Photoimm Photomed

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“…At present, dermatologists are still exploring the standardized protocol of using ALA‐PDT in patients with PCAS, especially in China. Stage of the disease and types of skin lesions may also affect the outcome of treatment 42 …”

Section: Treatment Optionsmentioning

confidence: 99%

Therapeutic options for perifolliculitis capitis abscedens et suffodens: A review

Zhang

et al. 2022

Dermatologic Therapy

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Perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic skin inflammatory disease characterized by relapsing folliculitis and painful, fluctuant abscesses, sinus tracts, and scars. The treatment of PCAS is challenging and clinical practice varies a lot, and how to choose the best treatment for PCAS is a real problem for clinicians. We reviewed articles providing treatment options for patients with PCAS in different databases. Dermatologists may find this review helpful to meet the challenges of PCAS management, but there is still a lack of authoritative guidelines. In the future, more robust randomized control trials are needed to determine the best treatment for PCAS. K E Y W O R D S biologics, dissecting cellulitis of the scalp (DCS), perifolliculitis capitis abscedens et suffodiens (PCAS), retinoids, treatment option 1 | INTRODUCTION Perifolliculitis capitis abscedens et suffodiens (PCAS), also known as dissecting cellulitis of the scalp (DCS) or Hoffman's disease, is a chronic skin inflammatory disease characterized by relapsing folliculitis and painful, fluctuant abscesses in the scalp that lead to the formation of sinus tracts and scarring. 1 PCAS may occur along with hidradenitis suppurativa (HS), acne conglobate and pilonidal sinus, termed the follicular occlusion tetrad. These four different clinical conditions appear to have common pathogenic events including follicular hyperkeratosis, poral obstruction, dilation and rupture, followed by neutrophilic and granulomatous inflammatory response, bacterial overgrowth, scarring, and sinus tract formations. 2 Treatment of PCAS is challenging and clinical practice varies a lot, while evidence-based treatment guidelines for PCAS are quite rare. Despite a paucity of robust and high-quality data on PCAS, this review focuses on different aspects of PCAS, especially on treatment options for PCAS, providing clinical inspirations for dermatologists. | CLINICAL MANIFESTATIONS AND HISTOPATHOLOGIC FEATURESLesions of PCAS are folliculitis at an early stage and becoming nodules and abscesses later, primarily on the occipital scalp or vertex, with symptoms of pain, itching or swelling. The nodules and abscesses rapidly develop into interconnecting, fluctuant, boggy sinus tracts, which discharge purulent and bloody secretions with a foul smell. With time, irreversible atrophic or hypertrophic scarring and cicatricial alopecia occur. PCAS presents as a chronic process with frequent episodes. 1,3 The histopathologic characteristics of PCAS usually depend on the clinical manifestation, which can range from early folliculitis, nodules or abscesses to sinus tracts or scars. In the early stage, histopathology findings show an infiltrate of lymphocytes and neutrophils involving the lower half of the dermis and gradually extended downward to subcutaneous fat. The disease progressed with vascular hyperplasia. In the late stage, the deep dermis and subcutaneous fat layer show the histologic characteristics of granuloma and eventually sinus tract and fibrosis develop. 4,5

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Treatments for Dissecting Cellulitis of the Scalp: A Systematic Review and Treatment Algorithm

Masson,

Jeong,

et al. 2023

Dermatol Ther (Heidelb)

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Background Dissecting cellulitis of the scalp (DCS) is a chronic inflammatory skin condition characterized by abscesses, nodules, fistulas, and scarring alopecia. Management of this oftentimes debilitating dermatosis can be challenging due to its recalcitrant nature. There is limited data regarding the efficacy of treatment options for DCS. Objective The aim of this study was to conduct a systematic review of the literature to explore the efficacy and safety of reported DCS treatments. Methods In October 2022, MEDLINE and EMBASE databases were searched for articles on treatments for DCS. Studies that contained outcome efficacy data for DCS treatments were included. Reviews, conference abstracts, meta-analyses, commentaries, non-relevant articles, and articles with no full-text available were excluded. Data extraction was performed by two independent reviewers. Results A total of 110 relevant articles with 417 patients were identified. A majority of studies (86.4%) were case reports or series. Treatment options included systemic antibiotics, oral retinoids, biologics, procedural treatments, combination agents, and topical treatments. Oral retinoids and photodynamic therapy were the most extensively studied medical and procedural interventions, respectively. Conclusion Overall, randomized controlled trials are needed to evaluate various treatment regimens for DCS and provide patients with a robust, evidence-based approach to therapy.

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Topical 5-aminolevulinic acid photodynamic therapy improved refractory acne conglobata and perifolliculitis capitis abscedens et suffodiens rather than hidradenitis suppurativa

Cited by 12 publications

References 15 publications

Systematic review of photodynamic therapy for the treatment of hidradenitis suppurativa

Systematic review of photodynamic therapy for the treatment of hidradenitis suppurativa

Therapeutic options for perifolliculitis capitis abscedens et suffodens: A review

Treatments for Dissecting Cellulitis of the Scalp: A Systematic Review and Treatment Algorithm

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