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Published on: April 16, 2018
Macular cutaneous amyloidosis treated with methyl aminolevulinate and daylight photodynamic therapy: A case report
Christina M Huang1,2, Lauren Lam2, Robert Gniadecki2
1School of Medicine, Queen's University, Kingston, ON, Canada.
Abstract:
Primary cutaneous amyloidosis is characterized by polymerization of extracellular amyloid precursors in β-pleated sheet conformation into larger fibrillar aggregates. Observation in models of Alzheimer's disease have noted that amyloid polymerization in the brain is blocked by reactive oxygen species. Singlet oxygen is formed in the skin during methyl aminolevulinate photodynamic therapy. Therefore, we speculate that type II photochemical reaction is responsible for the observed therapeutic activity of methyl aminolevulinate photodynamic therapy in our patient with primary cutaneous amyloidosis. Our case is the first report demonstrating the efficacy of daylight photodynamic therapy in primary cutaneous amyloidosis. Daylight photodynamic therapy may provide a convenient and cost-effective therapeutic option in primary cutaneous amyloidosis, and its efficacy should be further confirmed in prospective trials.
Insights
Daylight photodynamic therapy effectively treated primary cutaneous amyloidosis by generating singlet oxygen, preventing amyloid aggregation. This convenient, cost-effective treatment warrants further investigation in clinical trials.
Area of Science:
- Dermatology
- Photochemistry
- Biochemistry
Background:
- Primary cutaneous amyloidosis involves extracellular amyloid precursor polymerization into β-pleated sheet fibrils.
- Amyloid polymerization in Alzheimer's disease models is inhibited by reactive oxygen species.
Observation:
- Methyl aminolevulinate photodynamic therapy generates singlet oxygen in the skin.
- This study reports the first case of successful daylight photodynamic therapy for primary cutaneous amyloidosis.
Findings:
- The therapeutic effect of methyl aminolevulinate photodynamic therapy in primary cutaneous amyloidosis is attributed to a type II photochemical reaction involving singlet oxygen.
- Daylight photodynamic therapy demonstrated efficacy in treating primary cutaneous amyloidosis in this case report.
Implications:
- Daylight photodynamic therapy presents a potentially convenient and cost-effective treatment option for primary cutaneous amyloidosis.
- Further prospective trials are needed to confirm the efficacy and establish the role of daylight photodynamic therapy in managing primary cutaneous amyloidosis.
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