The Effect of Photodynamic Therapy Using Indole-3-Acetic Acid and Green Light on Acne Vulgaris

Background Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) has increasingly been used for the treatment of acne vulgaris and several studies have shown its clinical efficacy. However, ALA-PDT needs a relatively long incubation period and is frequently associated with adverse effects. Indole-3-acetic acid (IAA) has been introduced as a new photosensitizer for the treatment of acne in recent study. IAA-PDT requires only a short incubation period and the procedure is relatively painless in contrast to ALA-PDT. Objective To investigate the efficacy and safety of IAA- PDT in the treatment of acne. Methods Twenty-five patients with facial acne lesions were enrolled in this study. IAA-PDT was performed for five sessions at 1-week intervals (week 0~4). IAA was treated with 15 minute occlusion, and green light was given for 15 minutes. Clinical efficacy was determined by evaluating acne lesion counts, severity grading, and the Dermatology Life Quality Index (DLQI) at week 0, 2, 4, and 5. Sebum secretion and erythema index was measured by Sebumeter and Mexameter, respectively, at baseline and one week after each treatment session (week 1~5). Histopathological examination was performed at baseline and week 5. Adverse effects were recorded throughout the study. Results All the patients completed the study. Numbers of both inflammatory and non-inflammatory acne lesions were significantly decreased. Acne severity grade and the DLQI showed significant reduction. Sebum secretion and erythema were also reduced. Histopathological examination showed a reduction in inflammatory reactions. No adverse effects were observed except for transient pruritus in one patient. Conclusion PDT using IAA and green light was an effective, simple and safe treatment for acne.

[1]  N Simpson,et al.  Antibiotics in acne: time for a rethink , 2001, The British journal of dermatology.

[2]  M. Goldsmith Cellular signaling: new insights into the action of the plant growth hormone auxin. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[3]  E. Choi,et al.  Korean acne grading system , 2004 .

[4]  S. Ibbotson,et al.  Clinical and research applications of photodynamic therapy in dermatology: Experience of the scottish PDT centre , 2006, Lasers in surgery and medicine.

[5]  L. Folkes,et al.  Oxidative activation of indole-3-acetic acids to cytotoxic species- a potential new role for plant auxins in cancer therapy. , 2001, Biochemical pharmacology.

[6]  G. Tozer,et al.  Development of a novel enzyme/prodrug combination for gene therapy of cancer: horseradish peroxidase/indole-3-acetic acid , 2000, Cancer Gene Therapy.

[7]  Dong-Seok Kim,et al.  Experimental photodynamic therapy for liver cancer cell-implanted nude mice by an indole-3-acetic acid and intense pulsed light combination. , 2009, Biological & pharmaceutical bulletin.

[8]  J. Na,et al.  Indole‐3‐acetic acid: A potential new photosensitizer for photodynamic therapy of acne vulgaris , 2011, Lasers in surgery and medicine.

[9]  J C Kennedy,et al.  Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. , 1992, Journal of photochemistry and photobiology. B, Biology.

[10]  A. Finlay,et al.  The Dermatology Life Quality Index 1994–2007: a comprehensive review of validation data and clinical results , 2008, The British journal of dermatology.

[11]  J. Na,et al.  Tumor apoptosis by indole-3-acetic acid/light in B16F10 melanoma-implanted nude mice , 2009, Archives of Dermatological Research.

[12]  S. Tajima,et al.  Photodynamic therapy of acne vulgaris with topical δ‐aminolaevulinic acid and incoherent light in Japanese patients , 2001, The British journal of dermatology.

[13]  P. Wardman Indole-3-acetic acids and horseradish peroxidase: a new prodrug/enzyme combination for targeted cancer therapy. , 2002, Current pharmaceutical design.

[14]  W. Cunliffe,et al.  Topical aminolaevulinic acid‐photodynamic therapy for the treatment of acne vulgaris: a study of clinical efficacy and mechanism of action , 2004, The British journal of dermatology.

[15]  J. Na,et al.  Light-activated indole-3-acetic acid induces apoptosis in g361 human melanoma cells. , 2006, Biological & pharmaceutical bulletin.

[16]  Kyoung-Chan Park,et al.  Oxidation of indole-3-acetic acid by horseradish peroxidase induces apoptosis in G361 human melanoma cells. , 2004, Cellular signalling.

[17]  H. Gollnick,et al.  New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group. , 2009, Journal of the American Academy of Dermatology.

[18]  J. Hirschmann,et al.  Blue (or purple) toe syndrome. , 2009, Journal of the American Academy of Dermatology.

[19]  R. Anderson,et al.  Topical ALA-photodynamic therapy for the treatment of acne vulgaris. , 2000, The Journal of investigative dermatology.

[20]  J C Kennedy,et al.  Phototoxic damage to sebaceous glands and hair follicles of mice after systemic administration of 5-aminolevulinic acid correlates with localized protoporphyrin IX fluorescence. , 1990, The American journal of pathology.