Plasma Medicine: Applications of Cold Atmospheric Pressure Plasma in Dermatology

Thoralf Bernhardt, Marie Luise Semmler, Mirijam Schäfer, Sander Bekeschus, Steffen Emmert, Lars Boeckmann, Thoralf Bernhardt, Marie Luise Semmler, Mirijam Schäfer, Sander Bekeschus, Steffen Emmert, Lars Boeckmann

Abstract

The ability to produce cold plasma at atmospheric pressure conditions was the basis for the rapid growth of plasma-related application areas in biomedicine. Plasma comprises a multitude of active components such as charged particles, electric current, UV radiation, and reactive gas species which can act synergistically. Anti-itch, antimicrobial, anti-inflammatory, tissue-stimulating, blood flow-enhancing, and proapoptotic effects were demonstrated in in vivo and in vitro experiments, and until now, no resistance of pathogens against plasma treatment was observed. The combination of the different active agents and their broad range of positive effects on various diseases, especially easily accessible skin diseases, renders plasma quite attractive for applications in medicine. For medical applications, two different types of cold plasma appear suitable: indirect (plasma jet) and direct (dielectric barrier discharge-DBD) plasma sources. The DBD device PlasmaDerm® VU-2010 (CINOGY Technologies GmbH), the atmospheric pressure plasma jet (APPJ) kINPen® MED (INP Greifswald/neoplas tools GmbH), and the SteriPlas (Adtec Ltd., London, United Kingdom) are CE-certified as a medical product to treat chronic wounds in humans and showed efficacy and a good tolerability. Recently, the use of plasma in cancer research and oncology is of particular interest. Plasma has been shown to induce proapoptotic effects more efficiently in tumor cells compared with the benign counterparts, leads to cellular senescence, and-as shown in vivo-reduces skin tumors. To this end, a world-wide first Leibniz professorship for plasmabiotechnology in dermatology has been introduced to establish a scientific network for the investigation of the efficacy and safety of cold atmospheric plasma in dermatooncology. Hence, plasma medicine especially in dermatology holds great promise.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Copyright © 2019 Thoralf Bernhardt et al.

Figures

Figure 1
Figure 1
Examples of CE-certified plasma sources: (a) kINPen MED and (b) PlasmaDerm VU-2010.
Figure 2
Figure 2
Treatment of chronic ulceration with cold atmospheric pressure plasma (CAP): (a) kINPen MED and (b) PlasmaDerm VU-2010.
Figure 3
Figure 3
Example of successful wound healing after treatment with cold atmospheric pressure plasma (CAP): (a) chronic ulceration before CAP treatment and (b) complete healing for the first time since 14 years after CAP treatment for about 5 months.

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