Introduction: The photodynamic therapy (PDT), using 5-aminolevulinic acid (ALA) associated to IPL has become an issue of great interest to treat photodamaged skin with AKs. Objective: To determine the long term efficacy of 5-ALA+IPL in the treatment of the photodamaged skin with AKs, comparing to IPL alone. Material and methods: Nine patients with photodamaged facial skin were enrolled in this study. Two sessions of ALA-IPL were done on a split face and IPL alone on the other side, with a month interval. Results: AK lesions clearance was observed only on the area treated with ALAIPL (62.9%) after 3 months supervision. Recurrence of the improved lesions (70.6%) was observed in 12 month follow up. Improvement of melanoses, telangiectasia and wrinkles were observed on both sides, but more evident on the side treated with ALA-IPL. Conclusion: ALA-IPL brings improvement in photodamaged skin, including in AK lesions, what was not observed with IPL alone. Nevertheless, a long time of supervision is necessary to confirm the efficacy of the therapy.

Keywords: PHOTOCYNAMIC THERAPY, AMINOLEVULINIC ACID, REJUVENATION

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: 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

Topical photodynamic therapy is an established method of treating some types of non-melanoma skin cancers. Modifications to the standard protocol have recently been adopted that increase its therapeutic efficacy. This case study describes two female patients with multiple actinic keratoses who were simultaneously treated with the standard and modified protocols for methyl aminolevulinate and fractional radiofrequency combined with ultrasound in two different, symmetrically located, affected areas. This study’s objective is to evaluate the effectiveness of the transepidermal application of drugs in photodynamic therapy combined with new methods such as the proposed treatment.

Keywords: PHOTOCHEMOTHERAPY, AMINOLEVULINIC ACID , KERATOSIS ACTINIC, ABLATION TECHNIQUES