Photodiagnosis and Photodynamic Therapy最新文献

{"title":"Effects on choroid after repeated low-level red-light therapy in preclinical and clinical myopic children: a randomized controlled trial","authors":"Hongyu Wei ,&nbsp;Sahil Thakur ,&nbsp;Qin Zhu ,&nbsp;Yanrong Zhou ,&nbsp;Xuejun Cao ,&nbsp;Shuyuan Xiao ,&nbsp;Qin Chen ,&nbsp;Min Hu ,&nbsp;Hua Zhong","doi":"10.1016/j.pdpdt.2025.104651","DOIUrl":"10.1016/j.pdpdt.2025.104651","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate how choroidal thickness (CT) and choriocapillaris flow deficit density (CCD) change within 6000 µm of the macula following repeated low-level red-light (RLRL) therapy, and to assess whether early choroidal alterations can predict long-term myopia control.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of a prospective randomized controlled trial. Two hundred children with spherical equivalent refraction (SER) of -6.00D to +0.50D were randomized to receive either twice-daily RLRL therapy or no additional intervention (control). Axial length (AL), cycloplegic SER, CT, and CCD were measured at the baseline and at 1, 3, 6 and 12 months.</div></div><div><h3>Results</h3><div>Baseline characteristics were similar between groups. In the RLRL group, subfoveal choroidal thickness (SFCT) increased progressively over time, reaching its maximum at 12 months; by contrast, SFCT declined in controls. Within the 6000 µm macular zone, CT rose in the RLRL group but fell uniformly in the control group. Improvements on choriocapillaris blood flow were evident at 3 months post-RLRL, yet these changes were not sustained and did not correlate with longer-term choroidal thickening. A prediction model using only the “6-month SFCT change” demonstrated comparable accuracy for forecasting satisfactory myopia control at 12 months to more complex multivariable models.</div></div><div><h3>Conclusions</h3><div>RLRL therapy induces a marked and sustained thickening of the macular choroid within 6000 µm, while its effects on choriocapillaris perfusion are transient. Moreover, the magnitude of SFCT increase at 6 months alone provides a reliable early predictor of 12-month myopia control efficacy.</div><div><em>Trial Registration</em> This trial was registered at the Chinese Clinical Trial Registry on January 30, 2021, with trial registration number: ChiCTR2100042836. <span><span>https://www.chictr.org.cn/showprojEN.html?proj=120971</span><svg><path></path></svg></span></div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104651"},"PeriodicalIF":3.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photodynamic therapy in ocular oncology: A bibliometric analysis (1987–2024)","authors":"Ceren Türkoğlu ,&nbsp;Aslan Aykut","doi":"10.1016/j.pdpdt.2025.104654","DOIUrl":"10.1016/j.pdpdt.2025.104654","url":null,"abstract":"<div><h3>Background</h3><div>Photodynamic therapy (PDT) is a minimally invasive modality widely employed in ocular oncology, utilizing photosensitizers such as verteporfin to induce localized cytotoxic effects. While PDT is commonly applied in the management of benign intraocular tumors and selectively for malignant lesions, bibliometric analyses in this field remain scarce. This study aims to address this gap by analyzing bibliometric trends and mapping the evolution of PDT research in ocular oncology.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted using the Web of Science Core Collection, targeting PDT in ocular tumors. Data were screened for relevance, refined using OpenRefine, and analyzed in Microsoft Excel for publication trends. VOSviewer was used to visualize collaboration networks and keyword co-occurrence. Key indicators such as publication output, citations, authorship, institutional contributions, and journal distribution were assessed.</div></div><div><h3>Results</h3><div>A total of 177 publications (1987–2024) were identified, with original articles comprising 67.7 %. The United States led in publication count (<em>n</em> = 63), total citations (1074), and H-index (20). <em>Investigative Ophthalmology &amp; Visual Science</em> and <em>Retina</em> were the most prolific journals. A decline in publication volume was noted post-2020, coinciding with a global verteporfin shortage. Keyword analysis showed a primary focus on circumscribed choroidal hemangioma, with recent interest shifting toward metastasis and alternative therapies. The most prolific authors were Shields CL and Shields JA, while Schmidt-Erfurth U had the highest citation count.</div></div><div><h3>Conclusion</h3><div>This study presents a comprehensive bibliometric mapping of PDT in ocular oncology, highlighting research trends, influential contributors, and the impact of external factors on scholarly output.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104654"},"PeriodicalIF":3.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on “Photodynamic therapy with hematoporphyrin derivative for recurrent plantar cutaneous squamous cell carcinoma: A case report”","authors":"Guijun liu ,&nbsp;Tianming Ma","doi":"10.1016/j.pdpdt.2025.104650","DOIUrl":"10.1016/j.pdpdt.2025.104650","url":null,"abstract":"","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104650"},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of ALA-PDT for epidermoid cyst on the face: A retrospective study","authors":"Haiyan Zhang ,&nbsp;Yu Yan ,&nbsp;Yan Zhao ,&nbsp;Zhongxia Zhou ,&nbsp;Jiawen Gao ,&nbsp;Ronald Sroka ,&nbsp;Linglin Zhang ,&nbsp;Xiuli Wang","doi":"10.1016/j.pdpdt.2025.104641","DOIUrl":"10.1016/j.pdpdt.2025.104641","url":null,"abstract":"<div><div>Background: Epidermoid cysts are usually single, benign, keratin-filled cysts which occur mainly on the face and upper trunk of young adults. Surgical resection is the main treatment, which inevitably leaves scars and may recur. Photodynamic therapy (PDT) has been reported as a non-invasive and promising treatment for various skin diseases with cosmetic benefits.</div><div>Methods: 14 patients with single epidermoid cyst located on the face received ALA-PDT treatment. After the plum-blossom needle pretreatment, cyst was incubated with 5 % ALA cream for 30 min and then irradiated with 633 nm LED red light. If complete remission wasn’t achieved after one session of ALA-PDT treatment, more sessions would be repeated once every 1–2 weeks. Follow-ups were conducted every 2 weeks after the end of treatment.</div><div>Results: All patients achieved complete regression of cyst after 1 to 3 ALA-PDT sessions. None of the patients experienced recurrence or scarring during the follow-up period (0.5 to 28months). Mild adverse effects were observed, including transient pain, erythema, and edema.</div><div>Conclusion: In this observational study, ALA-PDT showed good efficacy and mild adverse reactions, suggesting that ALA-PDT is a promising treatment for epidermoid cysts on the face with cosmetic benefits.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104641"},"PeriodicalIF":3.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety evaluation of pulsed laser-activated injectable hydrogel for combined photodynamic and photothermal therapy in hypertrophic scar treatment","authors":"Xinling Zhang ,&nbsp;Xuejie Gao ,&nbsp;Yaqi Wei ,&nbsp;Yi Zhang ,&nbsp;Kun Zhang ,&nbsp;Hongtao Chen ,&nbsp;Lu Han ,&nbsp;Mengxin Mu ,&nbsp;Chendong Ji ,&nbsp;Hongyi Zhao","doi":"10.1016/j.pdpdt.2025.104647","DOIUrl":"10.1016/j.pdpdt.2025.104647","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To explore the efficacy and safety of pulsed laser-activated injectable hydrogel for combined photodynamic and photothermal therapy of hypertrophic scars.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this prospective study, indocyanine green (ICG) was used as a photosensitizer combined with hyaluronic acid (HA) to prepare ICG-HA hydrogel, and its photodynamic and photothermal properties were evaluated. The ex vivo photothermal experiments were conducted to assess the thermal effects on tissue integrity as a preliminary evaluation of safety. Human umbilical vein endothelial cells (HUVECs) were used as the experimental cell model to evaluate the in vitro effects of ICG-HA hydrogel under different therapies. A rabbit ear scar model (&lt;em&gt;n&lt;/em&gt; = 36) was established and randomly divided into 6 groups: ICG-HA hydrogels + single-pulse irradiation, single-pulse irradiation, ICG-HA hydrogels + continuous-pulse irradiation, continuous-pulse irradiation, ICG-HA hydrogels and control (&lt;em&gt;n&lt;/em&gt; = 6/group). Scar characteristics were monitored at 0, 1, 3, and 5 weeks using Ultrasound Doppler, colorimetry, VSS, and SEI assessments. At 1 and 5 weeks after ICG-HA hydrogels injection, histopathological analyses (hematoxylin and eosin (HE) staining, Masson's trichrome staining (MASSON) and CD31 immunohistochemical staining) were performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The ICG-HA hydrogel exhibited favorable photodynamic and photothermal properties while maintaining structural integrity during laser therapy. In vitro cell experiments, using CCK-8 for metabolic activity and live/dead staining for membrane integrity, demonstrated that the combined PDT and PTT treatment significantly reduced cell metabolic activity and induced cell death compared to either PDT or PTT alone (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). In the rabbit ear scar model, the VSS results showed that at 3 and 5 weeks post-treatment, both the ICG-HA hydrogels + single-pulse irradiation group and the ICG-HA hydrogels + continuous-pulse irradiation group had significantly lower VSS scores compared to the control group (&lt;em&gt;P&lt;/em&gt; &lt; 0.05), with the ICG-HA hydrogels + single-pulse irradiation group showing a more pronounced reduction (&lt;em&gt;P&lt;/em&gt; &lt; 0.01 at 3 weeks and &lt;em&gt;P&lt;/em&gt; &lt; 0.001 at 5 weeks). The similar trends were observed in the SEI scores. Colorimeter analysis revealed that, compared with the control group and the single-pulse irradiation group, the ICG-HA hydrogels + single-pulse irradiation group exhibited significantly lower color difference scores at 1, 3, and 5 weeks post-treatment (&lt;em&gt;P&lt;/em&gt; &lt; 0.001, &lt;em&gt;P&lt;/em&gt; &lt; 0.01 and &lt;em&gt;P&lt;/em&gt; &lt; 0.001, respectively). HE staining results showed that, at 1 and 5 weeks post-treatment, the ICG-HA hydrogels + single-pulse irradiation group had the most significant reduction in scar thickness compared with all other groups (&lt;em&gt;P&lt;/em&gt; &lt; 0.001). MASSON results indicated that, at 1 week post-treatment, the ICG-HA hydro","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104647"},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-aminolevulinic acid photodynamic therapy for the treatment of basal and squamous cell carcinoma: A systematic review","authors":"Nathalie C. Zeitouni ,&nbsp;Todd Schlesinger ,&nbsp;Meenal Kheterpal ,&nbsp;Puneet S. Jolly ,&nbsp;Jared Jagdeo","doi":"10.1016/j.pdpdt.2025.104649","DOIUrl":"10.1016/j.pdpdt.2025.104649","url":null,"abstract":"<div><h3>Background</h3><div>5-aminolevulinic acid photodynamic therapy (ALA-PDT) is used off-label in the US to treat basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Bowen disease (BD). We performed a systematic review to assess the efficacy and safety of published ALA-PDT protocols for these conditions.</div></div><div><h3>Methods</h3><div>A PubMed search was conducted through August 8, 2024, to identify studies evaluating 10 % or 20 % ALA-PDT in BCC, SCC, and BD. Randomized controlled trials, observational studies, and case series with &gt;5 patients were included. Quality assessment was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach.</div></div><div><h3>Results</h3><div>Fifty-eight studies were included in the analysis (BCC, <em>n</em> = 40; SCC; <em>n</em> = 9, BD, <em>n</em> = 27). Considerable heterogeneity was observed in ALA concentration, light sources, incubation times, and pretreatment strategies, precluding a standardized synthesis of outcomes. ALA-PDT achieved high clearance rates for superficial BCC and BD, with superior cosmetic outcomes compared to surgery or cryosurgery. Studies of ALA-PDT for SCC were limited with short follow-up times. Nodular BCC and SCC lesions demonstrated lower response rates, particularly with ALA-PDT monotherapy. Recurrence rates varied widely and were highest in patients with SCC. The most frequent adverse events were erythema, pain, and scaling.</div></div><div><h3>Conclusions</h3><div>This review provides a comprehensive summary of evidence-based ALA-PDT protocols for BCC, BD, and SCC, but published protocols are heterogeneous without a clear consensus. While ALA-PDT is effective, safe, and cosmetically favorable for less invasive tumors, protocol variability underscores the need for further randomized controlled trials to determine optimal treatment parameters.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104649"},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activated melanocytes and senescent collagen fibers predict laser-treated melasma outcomes: An optical biopsy–based prospective cohort study","authors":"Yen-Jen Wang ,&nbsp;Chang-Cheng Chang ,&nbsp;Yu-Hung Wu ,&nbsp;Ling Huang ,&nbsp;I-Ling Chen ,&nbsp;Yu-Chang Shih ,&nbsp;Hsing Cheng ,&nbsp;Jia-Wei Shen ,&nbsp;Meng-En Lu ,&nbsp;Hsiu-Mei Chiang ,&nbsp;Bor-Shyh Lin","doi":"10.1016/j.pdpdt.2025.104648","DOIUrl":"10.1016/j.pdpdt.2025.104648","url":null,"abstract":"<div><h3>Background</h3><div>Melasma Area and Severity Index (MASI) score only assesses the pigmentation rather than photoaging. Picosecond alexandrite laser (PAL) with diffractive lens array (DLA) can improve photoaging and has been approved for melasma treatment. Prediction for post-laser outcome is limited.</div></div><div><h3>Objective</h3><div>To in vivo compare the photoaging milieu altered by a PAL with DLA in melasma lesions and adjacent perilesions, and to delineate the predictive factors for outcomes.</div></div><div><h3>Methods</h3><div>An optical biopsy with cellular resolution full-field optical coherence tomography (CRFF-OCT) was set up to evaluate the dynamic changes. Quantification was performed with the computer-aided detection (CADe) system.</div></div><div><h3>Results</h3><div>The mean MASI score decreased significantly (<em>p</em> &lt; 0.001) in 12 of 15 patients but increased in the other three. An optical biopsy of 74,340 images showed the numbers of activated melanocytes and melanophages were significantly reduced post laser, and the basement membrane (BM) was repaired in melasma lesions, while basal lightening was noted in perilesions. The pre-treatment presence of activated melanocytes was associated with a high regional MASI score (<em>p</em> = 0.013), while the senescent collagen fibers and activated melanocyte patterns were associated with less MASI score improvement (<em>p</em> = 0.005). Senescent collagen fibers (<em>p</em> = 0.002) and baseline BM damage(<em>p</em> = 0.001) were strongly correlated to post-treatment melanophages. The baseline MASI score was not associated with activated melanocyte status or treatment outcomes.</div></div><div><h3>Conclusion</h3><div>Optical biopsy using CRFF-OCT revealed that patterns of activated melanocytes and senescent collagen fibers can serve as predictive markers for post-laser treatment outcomes. The photoaging characteristics of melasma were improved through the reduction of activated melanocytes and the repair of the BM.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104648"},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toric intraocular lens for cataracts with asymmetric corneal astigmatism: a literature review","authors":"Yuen Tsing Adeline Ho ,&nbsp;Sunny Chi Lik Au","doi":"10.1016/j.pdpdt.2025.104643","DOIUrl":"10.1016/j.pdpdt.2025.104643","url":null,"abstract":"","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104643"},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractal analysis for OCT-A images of central serous chorioretinopathy","authors":"Arturo Carta ,&nbsp;Angelique Donnio ,&nbsp;Stefano Dore ,&nbsp;Maurizio Fossarello ,&nbsp;Roberta Farci","doi":"10.1016/j.pdpdt.2025.104642","DOIUrl":"10.1016/j.pdpdt.2025.104642","url":null,"abstract":"<div><h3>Objective</h3><div>to analyze OCT-A choriocapillary layer (CCL) images of patients affected by central serous chorioretinopathy (CSC) by means of fractal analysis.</div></div><div><h3>Design</h3><div>a case-control study.</div></div><div><h3>Participants</h3><div>17 eyes of 16 patients affected by CSC were analyzed with OCT-A, and, successively, compared to 14 eyes of 8 healthy patients.</div></div><div><h3>Methods</h3><div>OCT-A images were opened in Image J software (<span><span>https://imagej.nih.gov/NIH</span><svg><path></path></svg></span>, Bethesda, MD, USA). Skeletonization process was applied, and subsequently, a fractal analysis was performed. Thereafter, fractal analysis by means of FracLac plugin was also realized: multifractal tool was applied. Data were then imported into Excel spreadsheet for statistical analysis. An independent t-Test between cases and controls was performed. A Mann-Whitney test between cases and controls, and between fractal values and sex of the participants was also applied; Spearman test was realized between fractal variables and the age and the visual acuity, respectively.</div></div><div><h3>Results</h3><div>mean fractal dimension (FD) of cases was 1,96±0,010; mean FD of controls was 1,86±0,02. Student t-test showed a significant difference between cases and controls (p=0,052). A statistically significant (p&lt;0.05) correlation between visual acuity and mean FD (rho=0.519, p=0,033) was found. No significant correlation between age and the mean FD was found (p&gt;0.519). No significant difference between males and females was found (p=0,245).</div></div><div><h3>Conclusions</h3><div>fractal analysis is a new, alternative method to evaluate retinal imaging in CSC, which can make a new assessment of this retinal disease.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"54 ","pages":"Article 104642"},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cimetidine (H2 histamine antagonist), Fexofenadine (H1 histamine antagonist), and Zinc sulphate in the treatment of erythropoietic protoporphyria","authors":"Hans Christian Wulf ,&nbsp;Peter A. Philipsen ,&nbsp;Catharina M. Lerche","doi":"10.1016/j.pdpdt.2025.104644","DOIUrl":"10.1016/j.pdpdt.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>Erythropoietic protoporphyria (EPP) patients are deficient in the ferrochelatase enzyme which converts protoporphyrin IX (PpIX) into heme, causing PpIX to accumulate in mature erythrocytes and skin. When skin is exposed to visible light, a phototoxic reaction occurs with clinical symptoms of erythema, pain, and edema. Cimetidine (H₂ histamine antagonist) may inhibit the δ-aminolevulinic acid synthase, reducing the build-up of PpIX. Fexofenadine (H₁ histamine antagonist) may reduce histamine release and associated phototoxicity symptoms. Zinc sulphate, by inhibiting the formation of reactive oxygen species, may lessen exposure-related pain.</div></div><div><h3>Methods</h3><div>Thirty-two EPP patients were treated for 68 summer seasons with Cimetidine, Fexofenadine, or Zinc sulphate. Primary outcome was the effect on PpIX levels. Treatment effects were registered in a quality-of-life questionnaire, including hours spent outdoors, time to sun induced skin pain, and maximal seasonal pain compared to a control year without treatment. Sun protection habits were also investigated.</div></div><div><h3>Results</h3><div>Our EPP patients had significant clinical improvement on Cimetidine or Zinc sulphate monotherapy. Fexofenadine had no significant effect. Combining Cimetidine with Zinc sulphate lowered PpIX levels by 5.7 %, and 94 % of patients taking Cimetidine and Zinc sulphate reported an 80 % increase in time spent outdoors. Time to symptom onset was prolonged by 92 %, maximal pain intensity was reduced by 29 %, and quality of life improved by 36 %.</div></div><div><h3>Conclusion</h3><div>Combination therapy with Cimetidine and Zinc sulphate is a safe, well tolerated, effective, low-cost treatment for EPP patients. Quality of life is improved, time to sun induced symptoms is prolonged, and pain is reduced.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"53 ","pages":"Article 104644"},"PeriodicalIF":3.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}