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      A single-blind, dose escalation, phase I study of high-fluence light-emitting diode-red light (LED-RL) on human skin: study protocol for a randomized controlled trial

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          Abstract

          Background

          Skin fibrosis is involved in a variety of pathologic conditions ranging from scar formation secondary to surgery or trauma to immune-mediated processes. Skin fibrosis is a significant international health problem with an estimated incidence of greater than 100 million people affected per year worldwide with few effective treatment options available. Preliminary in vitro data generated by our research group suggests that red light can function as a stand-alone treatment for skin fibrosis. To our knowledge, no prior clinical trials have been performed to determine the safety of high-fluence (dose) light-emitting diode-red light (LED-RL) phototherapy. The goal of this study is to evaluate the safety of LED-RL fluences from 160 J/cm 2 up to 640 J/cm 2 in healthy subjects.

          Methods/design

          This is a single-blind, dose escalation, randomized controlled, phase I study to evaluate the safety of high-fluence LED-RL on human skin. The protocol for dose escalation requires subjects be enrolled sequentially in groups of five. Within each group, three subjects will be randomized to LED-RL phototherapy and two subjects randomized to mock therapy. Subjects in group 1 randomized to LED-RL phototherapy will receive the maximum recommended starting dose (160 J/cm 2). LED-RL dose will be escalated in subsequent groups (320 J/cm 2, 480 J/cm 2 and 640 J/cm 2). The maximally tolerated dose (MTD) is defined as the dose level below the dose producing unacceptable but reversible toxicity and is considered to be the upper limit of subject tolerance. After either a MTD has been established, or the study endpoint of 640 J/cm 2 has been achieved, an additional 27 LED-RL phototherapy subjects (for a total of 30) and 18 mock therapy subjects (for a total of 20) (determined randomly) will be enrolled. Each subject will receive a total of nine procedures, three times per week for three consecutive weeks.

          Discussion

          This study may provide important safety information on the effects of high-fluence LED-RL phototherapy on human skin and help facilitate future phase II studies to evaluate the efficacy of high-fluence LED-RL as a potential noninvasive, safe, portable, at-home therapy for treatment of skin fibrosis.

          Trial registration

          ClinicalTrials.gov NCT02630303. Registered on 9 December 2015. 

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13063-016-1518-7) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          Skin scarring.

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            Quality of life of patients with keloid and hypertrophic scarring.

            Keloid and hypertrophic scarring represent chronic disfiguring dermatoses with a high resistance to therapy. The aim of our study was to assess for the first time the quality of life of patients with hypertrophic scars and keloids, because they suffer from quality of life impairment as much as patients with other chronic skin diseases. An item-pool was created modifying and supplementing the items of the Questionnaire on Experience with Skin Complaints. This questionnaire was distributed to 100 outpatients with keloids and hypertrophic scars. A factor analysis was used to identify the underlying dimensions. Two scales (psychological and physical impairment) of the questionnaire with nine and five items, respectively, were established. Test-retest reliability of the questionnaire was excellent (corr > 0.9). Good validity was suggested by the correlation of physical impairment with pain (P < or = 0.001), pruritus (P < 0.001), and the amount of restriction of mobility (P < 0.001). The psychological scale was associated with pain and restriction of mobility, although the correlations were lower. This study demonstrates for the first time an impairment of quality of life in a large group of patients with keloid and hypertrophic scarring.
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              If nothing goes wrong, is everything all right? Interpreting zero numerators.

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                Author and article information

                Contributors
                derekmkho@gmail.com
                ekraeva@email.arizona.edu
                twun@ucdavis.edu
                rrisseroff@ucdavis.edu
                (917) 837-9796 , jrjagdeo@gmail.com
                Journal
                Trials
                Trials
                Trials
                BioMed Central (London )
                1745-6215
                2 August 2016
                2 August 2016
                2016
                : 17
                : 385
                Affiliations
                [1 ]Dermatology Service, Sacramento VA Medical Center, Mather, CA USA
                [2 ]Department of Dermatology, University of California Davis, Sacramento, CA USA
                [3 ]Division of Hematology Oncology, Department of Internal Medicine, University of California Davis, Sacramento, CA USA
                [4 ]Division of Hematology Oncology, VA Northern California Healthcare System, Mather, CA USA
                [5 ]UC Davis Clinical and Translational Sciences Center, Sacramento, CA USA
                [6 ]Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY USA
                Article
                1518
                10.1186/s13063-016-1518-7
                4971661
                27484782
                b4ab7e83-f27f-48e7-a88b-86f33e1cce9d
                © Ho et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 January 2016
                : 22 July 2016
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2016

                Medicine
                light-emitting diode-red light,led-rl,high-fluence,phototherapy,skin fibrosis,wound healing,scar,keloid,rct

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