Introduction: Photodynamic therapy is a promising treatment for moderate photoaging. Objective: To evaluate the clinical and histological changes in elastin and collagen fibers following photodynamic therapy with 5-aminolevulinic acid. Methods: Female patients received three sessions of photodynamic therapy with 5-aminolevulinic acid, irradiated by a red-light (630 nm) light-emitting diode every 2 weeks.We evaluated the clinical improvement of photoaging, and also the increase in collagen and elastic dermal tissue by histomorphometry, using Picrosirius and Weigert-oxone staining, before treatment, 24 h after the first session, and 21 days after the third session.The results were evaluated using a semiquantitative method according to the following scores: 0 = absence of reaction, 0.5 = very weak reaction, 1.0 = minor reaction, 2.0 = moderate reaction, 3.0 = intense reaction. Results: Thirteen patients participated in the study.When assessed 21 days after the last treatment, 12 patients showed improvement in photoaging, especially regarding skin color and texture, clearing of solar melanosis, regression of actinic keratosis, and improvement of flaccidity. In the histomorphometric evaluation, an increase in collagen and elastic fiber tissue was observed.These outcomes have been statistically proven. Conclusions: Photodynamic therapy with 5-aminolevulinic acid, associated with red light, was clinically and histopathologically proven to be an effective treatment for clinical photoaging.

Keywords: SKIN AGING, PHOTOCHEMOTHERAPY, AMINOLEVULINIC ACID, COLLAGEN, ELASTIC TISSUE

Introduction: Androgenic alopecia is a progressive alteration of the scalp with few treatment options, which motivates the search for new local or systemic medications to control this pathology.
Objective: To evaluate patient tolerance for and identify the action mechanism of the Cellium® GC compound in the treatment of androgenic alopecia.
Methods: Male patients (n = 20) with androgenic alopecia participated in this open prospective study. The compound was used on the scalp twice a day, at home, for 12 con- secutive weeks. Biopsies were carried out before and after treatment to evaluate the alterations in the cutaneous immune response, cellular proliferation and anti-apoptosis activity. Questionnaires were administered to evaluate efficacy and patient satisfaction.
Results: Nineteen patients completed the study, with an average satisfaction of 8.3 out of 10. Immunohistochemical analyses of scalp biopsies showed a significant increase in the cutaneous immune response after treatment: 73.9% increase in CD1A+ Langerhans cells (p = 0.003, t paired test), 41.7% increase in the cellular proliferation marker Ki-67+ (p = 0.012), and an 89% increase in BCL-2+ anti apoptotic proteins (p = 001). The product was also found to be tolerable and safe.
Conclusions: Cellium® GC improved the skin''''''''s immune defense and the proliferation of keratinocytes, and produced high levels of patient satisfaction in the treatment of androgenic alopecia.

Keywords: ALOPECIA, BIOPSY, KERACINOCYTES, MINOXIDIL

Introduction: Photodynamic therapy destroys target cells by directly harming them, injuring the vascular stroma, and activating the immune system.
Objective: To study photoaged skin''''''''s immune response to photodynamic therapy.
Methods: Thirteen female patients underwent three treatment sessions with delta 5-aminolevulinic acid combined with 630 nm diode light. The immunohistochemical response of the skin''''''''s immune system was evaluated using the markers anti-CD1a, anti-CD4+, anti-CD8+, anti-TNFa, anti-IFNy and anti-IL4 before, 24 hours after the first session, and 21 days after the third session.
Results: At the final evaluation, patients demonstrated a decrease in CD4 and CD8 lymphocytes, an increase in interleukin-4 in the epidermis and dermis, and a reduction and an increase of TNF-a in the epidermis and dermis, respectively. The Langerhans cell and INF-y populations remained unchanged.
Conclusion: Regarding the immune system, photodynamic therapy did not cause changes in Langerhans cells; therefore, there was little local immunosuppression. CD4 and CD8 lymphocyte apoptosis was observed, suggesting that photodynamic therapy can be useful in treating inflammatory diseases. The changes in TNF-a and an increase of IL4 in the dermis and epidermis suggest a humoral type response, which was also evidenced by the absence of INFy.

Keywords: PHOTOCHEMOTHERAPY, AMINOLEVULINIC ACID , SKIN AGING