Document Detail


Photodynamic therapy with methyl 5-aminolevulinate acid might be ineffective in recalcitrant alopecia totalis regardless of using a microneedle roller to increase skin penetration.
MedLine Citation:
PMID:  20384755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Photodynamic therapy (PDT) with aminolevulinic acid or methyl 5-aminolevulinic acid (MAL) has been tried for the treatment of alopecia areata (AA). Unfortunately, the efficacy of PDT in treating AA is still being debated, and most clinical trials have produced disappointing results, which may have been because of the lack of treatment rationale or because of drug penetration. In several clinical trials of PDT in AA, the dermatologists suspected that skin preparations, including mechanical or chemical peeling, might be incomplete for drug penetration. OBJECTIVE: In this pilot study, the efficacy of PDT in treating AA was investigated, and the treatment effect of the use of a microneedle roller for the enhancement of the transepidermal drug delivery system was evaluated. MATERIALS AND METHODS: Eight Korean patients with alopecia totalis were enrolled in this study. Before the PDT, the right sides of the patients' scalps were prepared using 70% alcohol dressing and microneedle rolling, and the left sides (the control sides, without microneedle rolling) were only cleansed with 70% alcohol dressing. Immediately after the microneedle roller preparation, MAL was applied on the right scalp area under occlusion for 3 hours. Both sides were then illuminated with a red light (average wavelength, 630 nm; light dose, 37 J/cm(2)) for 7.5 minutes. Each patient received three treatments at 4-week intervals. A photograph of each patient was taken before and after the treatment. Biopsy was performed on the samples that were taken from both sides of the alopecia totalis lesions after 16 weeks (4 weeks after the final treatment). RESULTS: After the three treatments, none of the patients achieved hair growth in the microneedle-rolled lesion or in the unrolled lesion. Furthermore, there was no increment in the density of the anagen hair follicles and no difference in the histologic findings of the groups. CONCLUSION: PDT with MAL may not be effective for the treatment of alopecia totalis, regardless of the use of a microneedle roller to increase skin penetration.
Authors:
Kwang Ho Yoo; Jin Woong Lee; Kapsok Li; Beom Joon Kim; Myeung Nam Kim
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-02
Journal Detail:
Title:  Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]     Volume:  36     ISSN:  1524-4725     ISO Abbreviation:  Dermatol Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-07-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504371     Medline TA:  Dermatol Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  618-22     Citation Subset:  IM    
Affiliation:
Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alopecia Areata / drug therapy*,  pathology
Aminolevulinic Acid / administration & dosage*
Biopsy
Drug Delivery Systems / instrumentation*
Equipment Design
Female
Follow-Up Studies
Humans
Injections, Intradermal / instrumentation
Male
Miniaturization*
Needles*
Photochemotherapy / instrumentation*
Photosensitizing Agents / administration & dosage*
Pilot Projects
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Photosensitizing Agents; 106-60-5/Aminolevulinic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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