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Topical 5-aminolevulinic acid photodynamic therapy with novel approach successfully treated refractory deep male urethral condyloma acuminata: A retrospective case series. J Am Acad Dermatol 2022; 88:1166-1169. [PMID: 36513180 DOI: 10.1016/j.jaad.2022.11.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/13/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
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Dey A, Singhvi G, Puri A, Kesharwani P, Dubey SK. An insight into photodynamic therapy towards treating major dermatological conditions. J Drug Deliv Sci Technol 2022; 76:103751. [PMID: 36159728 PMCID: PMC9495279 DOI: 10.1016/j.jddst.2022.103751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Photodynamic therapy (PDT), as the name suggests is a light-based, non-invasive therapeutic treatment method that has garnered immense interest in the recent past for its efficacy in treating several pathological conditions. PDT has prominent use in the treatment of several dermatological conditions, which consequently have cosmetic benefits associated with it as PDT improves the overall appearance of the affected area. PDT is commonly used for repairing sun-damaged skin, providing skin rejuvenation, curbing pre-cancerous cells, treating conditions like acne, keratosis, skin-microbial infections, and cutaneous warts, etc. PDT mediates its action by generating oxygen species that are involved in bringing about immunomodulation, suppression of microbial load, wound-healing, lightening of scarring, etc. Although there are several challenges associated with PDT, the prominent ones being pain, erythema, insufficient delivery of the photosensitizing agent, and poor clinical outcomes, still PDT stands to be a promising approach with continuous efforts towards maximizing clinical efficacy while being cautious of the side effects and working towards lessening them. This article discusses the major skin-related conditions which can be treated or managed by employing PDT as a better or comparable alternative to conventional treatment approaches such that it also brings about aesthetic improvements thereof.
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Affiliation(s)
- Anuradha Dey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata 700056, India
| | - Gautam Singhvi
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani, Pilani Campus, Rajasthan, India-333031
| | - Anu Puri
- RNA Structure and Design Section, RNA Biology Laboratory (RBL), Center for Cancer Research, National Cancer Institute — Frederick, Frederick, MD, 21702, USA
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
- University Institute of Pharma Sciences, Chandigarh University, Mohali, Punjab, India
| | - Sunil Kumar Dubey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata 700056, India
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Zhan M, Tong Z, Chen S, Miao Y, Yang Y. Establishing a prediction model for recurrence of condyloma acuminatum. Eur J Med Res 2022; 27:183. [PMID: 36138469 PMCID: PMC9494849 DOI: 10.1186/s40001-022-00816-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
We collected the clinical data of 156 patients diagnosed with condyloma acuminatum (CA), including age, gender, marriage, education level, stay up late, smoking, drinking, number of sexual partners, HPV infection status of sexual partners, genitourinary and anal diseases, condom use, other diseases of HPV infection, location and number of warts, HPV typing, etc. Analyze the risk factors affecting the recurrence of CA, explore the influencing factors and independent influencing factors of CA recurrence, establish the prediction model of CA recurrence, and evaluate its prediction value. Univariate analysis showed that stay up late, HPV infection status of sexual partners, urogenital diseases, condom use, other diseases of HPV infection and the number of CA were the influencing factors of CA recurrence. Multivariate analysis showed that condom use (OR = 0.166), HPV infection status of sexual partners (OR = 4.848), number of warts (OR = 1.212) and urogenital diseases (OR = 3.179) were independent factors affecting the recurrence of CA (P < 0.05). Therefore, the prediction model of CA recurrence can be established, and the area under the curve AUC of the prediction model was calculated to be 0.867 (95% CI 0.812–0.923). The model established in this study has certain prediction value for the recurrence of CA and can be used to preliminarily predict the recurrence of CA.
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Affiliation(s)
- Mengyun Zhan
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China
| | - Zhenzhen Tong
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China
| | - Song Chen
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yu Miao
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yun Yang
- Department of Dermatology, Taikang Tongji (Wuhan) Hospital, Wuhan, 430050, China.
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Li C, Wang P, Wang D, Shi L, Zhou Z, Zhang L, Zhang G, Chen C, Wang X. Fluorescence kinetics study of twice laser irradiation based HpD-PDT for nonmelanoma skin cancer. Lasers Surg Med 2022; 54:945-954. [PMID: 35391497 DOI: 10.1002/lsm.23538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/31/2021] [Accepted: 03/03/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Hematoporphyrine injection (HpD)-based photodynamic therapy (HpD-PDT) has emerged as a promising cancer therapy. However, its tumor-targeting ability and metabolokinetics in nonmelanoma skin cancer (NMSC) have not been well explored. Importantly, photodynamic diagnosis is widely used for cancer lesion assessment and positioning to ensure effective therapy, while the photosensitizer metabolic kinetics study is utilized for biosafety assessment and light-protection instruction. These are particularly important for the optimization of therapeutic parameters. OBJECTIVES In the present study, NMSC patients were subjected to twice laser irradiation-based HpD-PDT strategy. Broadly, the study aimed to assess long-term variations in fluorescence (FL) intensity in vivo in NMSC patients after intravenous (i.v.) administration of HpD, and thus obtain information regarding metabolism, biosafety, and light-protection instruction for HpD during the therapy. METHODS In vitro experiments were used for the evaluation of absorption and fluorescent characterization of HpD in aqueous solution and cutaneous squamous cell carcinoma (SCC) cells. For in vivo assessment, 20 patients with NMSC, including SCC, basal cell carcinoma (BCC), Bowen disease (BD), extramammary Paget's disease (EMPD), and malignant proliferating tricholemmoma (APT), were recruited, and treated with HpD-PDT. To evaluate the selectivity and pharmacokinetics of HpD in vivo, relative changes in FL intensity for lesional, perilesional, and nonlesional skin of nonmelanoma skin cancer patients, before and after HpD injection, were semiquantitatively analyzed for 1 month, using the FL detection system and Wood's lamp. RESULTS The absorption and FL spectra were detected and semiquantitatively analyzed in HpD diluted solution and SCC cells after coincubation with HpD. After i.v. administration of HpD in EMPD patients, FL was detected in the skin lesions at 24 hours, and it was characterized by clear edges. Importantly, FL intensity in the skin lesions increased significantly at 48 and 72 hours postinjection, which was suitable for HpD-PDT. After 72 h, it decreased gradually and reached close to the baseline value at 4 weeks postinjection. No severe side effects were observed during HpD injection and the therapy. Urinary tract infection was recorded in one patient (with a previous history of recurrent urinary tract infections) after HpD-PDT, and the patient was cured afterward. Transient light was observed in two patients after HpD-PDT and they soon recovered after therapy. CONCLUSIONS The present study reported a significant increase in FL intensities at 48 and 72 hours after i.v. administration of HpD in patients with nonmelanoma skin cancers, which indicated accumulation of HpD at the cancer site. Importantly, HpD was found to be safe for NMSC patients. After therapy, FL intensities decreased, which indicated expending and metabolization of HpD. Thus, the results of the present study highlighted the suitability of a twice red-light laser irradiation strategy for the application of HpD-PDT in nonmelanoma skin cancer treatment.
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Affiliation(s)
- Chunxiao Li
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dixin Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhongxia Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chengqian Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Yao H, Yan J, Zhou Z, Shen S, Wu Y, Liu P, Zhang H, Wang X. A chlorin e6 derivative‐mediated photodynamic therapy for patients with cervical and vaginal low‐grade squamous intraepithelial lesions: a retrospective analysis. TRANSLATIONAL BIOPHOTONICS 2022. [DOI: 10.1002/tbio.202200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Hongxia Yao
- Shanghai First Maternity and Infant Hospital Tongji University School of Medicine Shanghai China
| | - Jia Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Zhongxia Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Shuzhan Shen
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Yun Wu
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Pei Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital Tongji University School of Medicine Shanghai China
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Hua H, Zhou S, Gu L, Shi Z, Gu L, Zhou B. Multiple-type HPV infection predicting condyloma acuminatum recurrence after aminolevulinic acid photodynamic therapy. Photodiagnosis Photodyn Ther 2021; 36:102538. [PMID: 34536607 DOI: 10.1016/j.pdpdt.2021.102538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/22/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Aminolevulinic acid photodynamic therapy (ALA-PDT) has been widely used in the treatment of condyloma acuminatum (CA), but there is a lack of reports on clinical factors related to CA relapse after photodynamic therapy. METHODS The clinical data of patients with CA treated with ALA-PDT from April 2018 to December 2019 were retrospectively analyzed, including HPV type, follow-up time and recurrence within 6 months after treatment. The patients were classified into single-type HPV infection and multiple-type HPV infection groups. Besides, the patients were also classified into high-risk HPV infection, low-risk HPV infection, and low + high-risk HPV infection groups. Univariate and multivariate COX regression was performed to analyze whether HPV type was related with CA relapse after photodynamic therapy. RESULTS A total of 161 CA patients who underwent ALA-PDT were analyzed in this study. CA recurred in 20 patients within 6 months after treatment, with a recurrence rate of 12.4%. Of them, the patients with multiple-type HPV infection made up 85%. Multivariate COX regression analysis revealed that multiple-type HPV infection was associated with CA recurrence (HR:5.0; 95% CI: 1.1-21.4; P = 0.032). Of the patients with CA recurrence, 70% developed low + high-risk infections, a proportion significantly higher than that in patients without CA relapse (16.3%, P < 0.001). Using low-risk infection as a reference, low + high-risk infection was positively correlated with postoperative recurrence (HR: 6.7; 95% CI: 1.6-26.2; P = 0.006). CONCLUSION Multiple-type HPV infection were closely associated with CA recurrence after photodynamic therapy.
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Affiliation(s)
- Hui Hua
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, 226001, China
| | - Shu Zhou
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, 226001, China
| | - Li Gu
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, 226001, China
| | - Zhinan Shi
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, 226001, China
| | - Liqun Gu
- Department of Dermatology, Nantong Third People's Hospital Affiliated to Nantong University, Nantong, 226001, China
| | - Bingrong Zhou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Willis JA, Cheburkanov V, Kassab G, Soares JM, Blanco KC, Bagnato VS, Yakovlev VV. Photodynamic viral inactivation: Recent advances and potential applications. APPLIED PHYSICS REVIEWS 2021; 8:021315. [PMID: 34084253 PMCID: PMC8132927 DOI: 10.1063/5.0044713] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/13/2021] [Indexed: 05/04/2023]
Abstract
Antibiotic-resistant bacteria, which are growing at a frightening rate worldwide, has put the world on a long-standing alert. The COVID-19 health crisis reinforced the pressing need to address a fast-developing pandemic. To mitigate these health emergencies and prevent economic collapse, cheap, practical, and easily applicable infection control techniques are essential worldwide. Application of light in the form of photodynamic action on microorganisms and viruses has been growing and is now successfully applied in several areas. The efficacy of this approach has been demonstrated in the fight against viruses, prompting additional efforts to advance the technique, including safety use protocols. In particular, its application to suppress respiratory tract infections and to provide decontamination of fluids, such as blood plasma and others, can become an inexpensive alternative strategy in the fight against viral and bacterial infections. Diverse early treatment methods based on photodynamic action enable an accelerated response to emerging threats prior to the availability of preventative drugs. In this review, we evaluate a vast number of photodynamic demonstrations and first-principle proofs carried out on viral control, revealing its potential and encouraging its rapid development toward safe clinical practice. This review highlights the main research trends and, as a futuristic exercise, anticipates potential situations where photodynamic treatment can provide a readily available solution.
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Affiliation(s)
- Jace A. Willis
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Vsevolod Cheburkanov
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Giulia Kassab
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Jennifer M. Soares
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Kate C. Blanco
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | | | - Vladislav V. Yakovlev
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
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Chinese guidelines on the clinical application of 5-aminolevulinic acid-based photodynamic therapy in dermatology (2021 edition). Photodiagnosis Photodyn Ther 2021; 35:102340. [PMID: 33991660 DOI: 10.1016/j.pdpdt.2021.102340] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/12/2021] [Accepted: 05/07/2021] [Indexed: 12/24/2022]
Abstract
Photodynamic Therapy with 5-aminolevulinic acid (ALA-PDT) has been widely applied in the treatment of skin diseases in China. To further standardize, guide, and promote the clinical applications of ALA-PDT in dermatology, the Chinese Society of Dermatology, Chinese Association of Rehabilitation Dermatology, Photomedicine Therapeutic Equipment Group of Committee on Skin Disease, and Cosmetic Dermatology of China Association of Medical Equipment invited relevant experts engaged in ALA-PDT to revise and update the first edition of "Clinical application of 5-aminolevulinic acid-based photodynamic therapy: an expert consensus statement" and establish a more current edition, to provide an updated reference for Chinese dermatologists in clinical practice. In the guideline, the expert group reached consensus opinions on ALA-PDT with regard to mechanisms of action, therapeutic protocol, clinical applications, adverse reactions and countermeasures, precautions, care, and evaluation of efficacy.
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Ran R, Wang M, Li X, Liu Q. A prospective study of photodynamic therapy for cervical squamous intraepithelial lesion. Photodiagnosis Photodyn Ther 2021; 34:102185. [PMID: 33454394 DOI: 10.1016/j.pdpdt.2021.102185] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/19/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for the treatment of cervical squamous intraepithelial lesion (SIL). METHODS We prospectively screened and enrolled patients with cervical SIL and persistent high-risk human papilloma virus (HR-HPV) infection to receive ALA-PDT from March 27, 2019, to January 23, 2020, at Beijing Youan Hospital, China. The primary outcome was the remission rate of SIL and HPV. The secondary outcome was the symptom improvement and adverse events of ALA-PDT in these cases. RESULTS 54 patients with cervical SIL and persistent HR-HPV infection were enrolled and divided these individuals into three groups: high-grade squamous intraepithelial lesion (HSIL) group (10 patients), low-grade squamous intraepithelial lesion (LSIL) group (33 patients), and simple HR-HPV infection group (11 patients). 49 of 54 patients finished six sessions treatment and 46 of 49 patients complete the follow-up. After six sessions' treatment, HR-HPV remission rates were 71.43 %(5/7)in the simple HR-HPV infection group, 63.64 %(14/22) in the LSIL group, and 50 %(4/8) in the HSIL group. The histology remission rates were 80 %(4/5) in the simple HR-HPV infection group, 69.57 %(16/23)in the LSIL group, and 75 % (6/8) in the HSIL group. Symptoms improvement rates in the simple HR-HPV infection, LSIL group, and HSIL group were 100 %(5/5), 66.67 %(5/15) and 71.43 %(5/7). No severe adverse events or systemic side effects were observed in treatment. CONCLUSION Topical ALA-PDT is an effective and safe treatment for cervical SIL.
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Affiliation(s)
- Ran Ran
- Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Ming Wang
- Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiulan Li
- Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Qing Liu
- Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
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Zhang H, Shi L, Zhang Y, Wang P, Zhang G, Cao Y, Zhou Z, Wang X. Modified photodynamic therapy to minimize pain in the treatment of condylomata acuminata: A prospective, randomized, self-controlled study. Photodiagnosis Photodyn Ther 2020; 32:101915. [PMID: 32634656 DOI: 10.1016/j.pdpdt.2020.101915] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pain is a major concern associated with conventional photodynamic therapy (C-PDT). OBJECTIVE To evaluate the efficacy, pain and safety of modified photodynamic therapy(M-PDT) for the treatment of condylomata acuminata. METHODS A prospective, randomized, self-controlled study was conducted. Warts were randomized to the M-PDT or C-PDT side. 5-aminolevulinic acid (ALA; 20 %) was incubated for 3 h before patients were exposed to LED red light (100 J/cm2) on the C-PDT side and for 30 min before being exposed to LED red light (300 J/cm2) on the M-PDT side. Treatment was administered with 1-week interval for three weeks. The clearance rates were determined at one week and the recurrence rates at 4, 8, and 12 weeks after treatment. The pain and other side effects were also investigated. RESULTS A total of 24 patients with condylomata acuminata were enrolled in this trial. Twenty patients completed the trial. The clearance rates were 98.17 % in the M-PDT side and 98.20 % in the C-PDT side(P > 0.05). The recurrence rates were 11.11 % and 10.53 % (P > 0.05). However, M-PDT was almost painless (mean score 0.3 ± 0.47, range 0∼1), which was significantly less than that on the C-PDT side (mean score 3.6 ± 0.94, range 0∼1) (P < 0.05). Local erythema, mild edema and erosion were observed on both sides. CONCLUSION The modified PDT is basically painless with similar efficacy to conventional PDT, which is a major breakthrough of pain management in PDT.
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Affiliation(s)
- Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yajing Cao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhongxia Zhou
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
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Borgia F, Giuffrida R, Coppola M, Princiotta R, Vaccaro M, Guarneri F, Cannavò SP. Efficacy and safety of conventional versus daylight photodynamic therapy in children affected by multiple facial flat warts. Photodiagnosis Photodyn Ther 2020; 31:101819. [PMID: 32464266 DOI: 10.1016/j.pdpdt.2020.101819] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND facial flat warts (FFWs) are a superficial viral skin disease, extremely common in childhood. Recently, conventional photodynamic therapy (C-PDT) has been used for the treatment of FFWs with good outcome. The efficacy of daylight photodynamic therapy (DL-PDT) has not yet been evaluated. OBJECTIVES to investigate and assess the efficacy and safety of C-PDT versus DL-PDT using 10% aminolevulinic acid (ALA) in the treatment of recalcitrant FFWs in a paediatric setting. MATERIALS AND METHODS 30 consecutive patients aged <18 years with FFWs of the face were included and randomly divided into two groups: group A (15 patients) was treated with C-PDT and group B (15 patients) with DL-PDT. Patients underwent treatments for three times with 1-month intervals. The response was assessed on week 4,812 and 24 (T4,T8,T12,T24) and scored as excellent (75-100% reduction of total wart count), very good (74-50% reduction), good (49-25% reduction), poor (<25% reduction or no response). Any adverse event occurring during/after ALA application/irradiation as well as pain intensity were recorded at each visit. RESULTS at T4 and T8 no excellent response was achieved in both groups. At week 12, excellent response was observed in 53.3% of group A patients vs 0% of group B patients, although in the latter 66.7% of patients achieved a very good response. Excellent outcome raised to 73.3% and 80% in group A and B, respectively, at week 24. Poor response to therapy was observed in 26.7% of patients in group A and 20% in group B. Both treatment modalities were well tolerated, with transient pain, irritation and hyperpigmentation as main side effects. CONCLUSIONS ALA-PDT is effective and safe for FFWs, with striking cosmetic results and no recurrence. Compared with conventional modality, DL-PDT is better tolerated, time-saving, nearly painless and greatly appreciated by young patients.
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Affiliation(s)
- Francesco Borgia
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy.
| | - Marialorena Coppola
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
| | - Rosaria Princiotta
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
| | - Fabrizio Guarneri
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
| | - Serafinella Patrizia Cannavò
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, via Consolare Valeria no 1, Messina 98125, Italy
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Shi L, Liu P, Liu J, Yang Y, Chen Q, Zhang Y, Zhang H, Wang X. Application of 5‐aminolevulinic acid‐photodynamic therapy in common skin diseases. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.201900028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Pei Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Jia Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Yuling Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Qi Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine Shanghai China
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13
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Yao H, Zhang H, Pu X, Shi L, Zhang Y, Wang P, Zhang G, Zhou Z, Zhou W, Wang X. Photodynamic therapy combined with carbon dioxide laser for low-grade vaginal intraepithelial neoplasia: A retrospective analysis. Photodiagnosis Photodyn Ther 2020; 30:101731. [PMID: 32171880 DOI: 10.1016/j.pdpdt.2020.101731] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/09/2020] [Accepted: 03/09/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with a carbon dioxide laser (CO2 laser + PDT) versus CO2 laser for the treatment of low-grade vaginal intraepithelial neoplasms (vaginal LSIL). METHODS We recruited 40 patients with vaginal LSIL and persistent HR-HPV infection and divided these individuals into two groups. The CO2 laser + PDT group (20 patients) received one CO2 laser treatment and three treatments of ALA-PDT over a one-week interval. The CO2 laser group (20 patients) received up to three CO2 laser treatments. All patients were followed up at 1 month, 3 month, 6 month and 1 year. Hybrid capture HPV DNA assay and colposcopic biopsy were performed for both groups before treatment and during each of the follow-ups. Adverse effects were also assessed. RESULTS The complete remission (CR) rates were 65 % (13/20) in the CO2 laser group and 85 % (17/20) in the CO2 laser + PDT group (p > 0.05). HR-HPV remission rates were 25 % (5/20) in the CO2 laser group and 95 % (19/20) in the CO2 laser + PDT group (p < 0.05) at one year after treatment. In the CO2 laser group, one patient experienced severe bleeding during treatment. Twelve patients had varying degrees of adhesions and vaginal scar stenosis. One patient underwent vaginal "dead angle" after repeated CO2 laser treatment. No severe adverse events or systemic side effects were observed in the CO2 + PDT group. CONCLUSION Topical ALA-PDT combined with CO2 laser is an effective, safe, and well-tolerated treatment for vaginal LSIL and HR-HPV infections.
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Affiliation(s)
- Hongxia Yao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Xiaowen Pu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Lei Shi
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Yunfeng Zhang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Peiru Wang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Guolong Zhang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Zhongxia Zhou
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Weiqiang Zhou
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
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14
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Yin G, Zhang Y, Geng M, Cai B, Zheng Y. Cure of condyloma acuminata covering the glans penis using aminolevulinic acid/photodynamic therapy. Photodiagnosis Photodyn Ther 2020; 30:101658. [PMID: 32112970 DOI: 10.1016/j.pdpdt.2020.101658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/27/2019] [Accepted: 01/10/2020] [Indexed: 10/24/2022]
Abstract
Condyloma acuminata are a type of verrucous hyperplasia in the genital and perianal areas caused by human papilloma virus (HPV) infection. Traditional treatment methods for condyloma acuminata, such as topical medications, carbon dioxide (CO2) laser, cryotherapy, and surgical excision, can be effective at removing warts, however, they do not eliminate subclinical and latent HPV infection, resulting in a high recurrence rate and even leaving trauma and scars. We report a case of condyloma acuminata covering the glans penis, considering our patient had a singular, large lesion, thus, to reduce the risk of recurrence and minimize the trauma caused by treatment, we chose ALA/photodynamic therapy (ALA-PDT). We provided eight rounds of ALA-PDT at a treatment interval of 7 days, the skin lesion disappeared completely, leaving a chapped, flushed glans without scarring. There was no recurrence during the 6-month follow-up period. Thus, we firmly believe that ALA-PDT is an effective, safe, and curative treatment, and is worth popularizing in clinical practice.
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Affiliation(s)
- Guangwen Yin
- The First Affiliated Hospital of Zhengzhou University, China.
| | - Yidan Zhang
- The First Affiliated Hospital of Zhengzhou University, China
| | - Mengmeng Geng
- The First Affiliated Hospital of Zhengzhou University, China
| | - Bingjie Cai
- The First Affiliated Hospital of Zhengzhou University, China
| | - Yunpeng Zheng
- The First Affiliated Hospital of Zhengzhou University, China
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15
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Zhao W, Shan XF, Wang CL, Liu XZ, Li Z, Xiao HL, Li ZW, Zheng RT, Hou JL, Tian HQ. Topical 5-aminolevulinic acid photodynamic therapy for intra anal-rectal warts. J DERMATOL TREAT 2019; 31:241-244. [PMID: 30990345 DOI: 10.1080/09546634.2019.1594670] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Condylomata acuminata (CA) are a common sexually transmitted disease. The recurrence rate of condyloma acuminatum using traditional treatments is higher than that of applying photodynamic therapy, and a variety of adverse reactions after treatment. At the same time, different parts of condyloma acuminatum after treatment recurrence rate is also different, especially for intra anal-rectal warts.Objective: To evaluate whether using photodynamic therapy (PDT) can effectively reduce recurrence of condylomata acuminata for intra anal-rectal warts.Methods: After the confirmation of the diagnosis of intra anal-rectal warts, the patients were treated with PDT with 5-aminolevulinic acid hydrochloride (ALA). PDT was performed with irradiation of 18-36 J/cm2 at an irradiance of 20-40 mW/cm2 with light-emitting diode (LED) light energy, wavelength 635 nm. We used a special PDT light equipment for intra anal-rectal area warts. PDT was repeated once every week for 4 weeks.Results: After PDT, the complete clearance rate was 76.1% (35 of 46 patients). At the end of the 12 weeks followed, recurrence occurred in five cases. We recorded pain in all 46 patients and the average visual analog scale (VAS) pain score was 6.96 ± 1.41 points.Conclusion: The treatment with PDT is effective in reducing the high rate of recurrence for intra anal-rectal warts. Pain is still a great challenge for the therapy.
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Affiliation(s)
- Wei Zhao
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Xiao-Feng Shan
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Chang-Liang Wang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Xin-Zhou Liu
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Zhen Li
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Hai-Lu Xiao
- Jining Medical College Affiliated Hospital of Jining Medical University, Jining, China
| | - Zhong-Wei Li
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Rong-Tao Zheng
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Jian-Ling Hou
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
| | - Hong-Qing Tian
- Shandong Provincial Institute of Dermatology and Venereology, Shandong, China
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Wiehe A, O'Brien JM, Senge MO. Trends and targets in antiviral phototherapy. Photochem Photobiol Sci 2019; 18:2565-2612. [PMID: 31397467 DOI: 10.1039/c9pp00211a] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Photodynamic therapy (PDT) is a well-established treatment option in the treatment of certain cancerous and pre-cancerous lesions. Though best-known for its application in tumor therapy, historically the photodynamic effect was first demonstrated against bacteria at the beginning of the 20th century. Today, in light of spreading antibiotic resistance and the rise of new infections, this photodynamic inactivation (PDI) of microbes, such as bacteria, fungi, and viruses, is gaining considerable attention. This review focuses on the PDI of viruses as an alternative treatment in antiviral therapy, but also as a means of viral decontamination, covering mainly the literature of the last decade. The PDI of viruses shares the general action mechanism of photodynamic applications: the irradiation of a dye with light and the subsequent generation of reactive oxygen species (ROS) which are the effective phototoxic agents damaging virus targets by reacting with viral nucleic acids, lipids and proteins. Interestingly, a light-independent antiviral activity has also been found for some of these dyes. This review covers the compound classes employed in the PDI of viruses and their various areas of use. In the medical area, currently two fields stand out in which the PDI of viruses has found broader application: the purification of blood products and the treatment of human papilloma virus manifestations. However, the PDI of viruses has also found interest in such diverse areas as water and surface decontamination, and biosafety.
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Affiliation(s)
- Arno Wiehe
- biolitec research GmbH, Otto-Schott-Str. 15, 07745 Jena, Germany. and Institut für Chemie und Biochemie, Freie Universität Berlin, Takustr. 3, 14195 Berlin, Germany
| | - Jessica M O'Brien
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
| | - Mathias O Senge
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland.
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17
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Tu P, Zhang H, Zheng H, Gu H, Xu J, Tao J, Wang H, Zhu X, Wang X. 5-Aminolevulinic photodynamic therapy versus carbon dioxide laser therapy for small genital warts: A multicenter, randomized, open-label trial. J Am Acad Dermatol 2019; 84:779-781. [PMID: 31374308 DOI: 10.1016/j.jaad.2019.07.073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 05/21/2019] [Accepted: 07/24/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Ping Tu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai
| | - Heyi Zheng
- Department of Dermatology and Venereology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Heng Gu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing
| | - Jinhua Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai
| | - Jining Tao
- Shanghai Fudan-Zhangjiang Bio-Pharmaceutical Co., Ltd, Shanghai
| | - Hongwei Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai
| | - Xuejun Zhu
- Department of Dermatology and Venereology, Peking University First Hospital, Beijing.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai.
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Yang Y, Zhang Y, Zou X, Guo X, Lin H. Perspective clinical study on effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating condylomata acuminata in pregnancy. Photodiagnosis Photodyn Ther 2019; 25:63-65. [PMID: 30447414 DOI: 10.1016/j.pdpdt.2018.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/07/2018] [Accepted: 11/13/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To observe the clinical efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating vulval condylomata acuminata (CA) in pregnancy. METHODS The clinical efficacies of ALA-PDT on 16 cases of CA in pregnancy as well as cryotherapy on 22 cases of CA in pregnancy were analyzed in this prospective study. RESULTS The treatment group showed a wart clearance rate of 93.8% after 3 PDT treatments, while the control group showed a wart clearance rate of 72.7% after 3 cryotherapy treatments. After the 3-month follow-up period, the treatment group registered a recurrence rate of 6.3%, whereas the control group recorded a recurrence rate of 36.4%, indicating a statistically significant difference (χ2 = 4.674, p = 0.031 < 0.05). After the 1-month postpartum follow-up period, the newborns grew and developed well, without any abnormality in physical examinations. CONCLUSION ALA-PDT is safe and effective in treating CA in pregnancy.
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Affiliation(s)
- Yuguang Yang
- Department of Dermatology of the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China.
| | - Yunjie Zhang
- Department of Dermatology of the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
| | - Xianbiao Zou
- Department of Dermatology of the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
| | - Xiaojuan Guo
- Department of Dermatology of the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
| | - Hui Lin
- Department of Dermatology of the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
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19
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Hu S, Yang Y, Jiang B, Su D, Zhang L, Huang Z, Zhang F. Treatment of condyloma acuminatum using the combination of laser ablation and ALA-PDT. Photodiagnosis Photodyn Ther 2018; 25:193-196. [PMID: 30579992 DOI: 10.1016/j.pdpdt.2018.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/10/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Human papilloma virus (HPV) infection and condyloma acuminatum (CA) in the genital area often exist in extensive and multi-point fashion. Laser ablation combined with topical photodynamic therapy (PDT) is a feasible approach for genital CA but its effectiveness and limitations need to be evaluated. METHODS This single-arm prospective study consisted of 100 newly diagnosed CA cases of both sexes. All patients underwent laser ablation and then three times aminolaevulinic acid-based photodynamic therapy (ALA-PDT). The outcomes were evaluated and analyzed 3 months after the treatment. RESULTS A total of 98 patients completed the study. Except for 6 patients (4 males and 2 females) showed some residual lesions other 92 patients (93.8%) showed complete cure. However, there were 18 patients (10 males and 8 females) showed new lesions near the treated areas. Although the HPV types of 18 patients before and after treatment were not completely consistent, 94.4% percent of patients (17/18) had the same HPV type as the primary lesion, which suggested that these late-onset CA might have latent infection or subclinical infection in the early stage of the disease but the length of the incubation period was longer. CONCLUSION Combination approach is effective in treating genital CA and preventing CA recurrence. But its limitations need to be recognized as the late-onset CA might occur near the treated area. The treatment plan needs to be optimized for multiple genital CA lesions.
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Affiliation(s)
- Shaoshan Hu
- Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, 150001, China
| | - Yun Yang
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Bingbing Jiang
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Dongqiang Su
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Likun Zhang
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Zheng Huang
- Medical Photonics Center, Fujian Normal University, Fuzhou, 350007, China
| | - Feng Zhang
- Department of Dermatology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
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20
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Shi HJ, Song H, Zhao QY, Tao CX, Liu M, Zhu QQ. Efficacy and safety of combined high-dose interferon and red light therapy for the treatment of human papillomavirus and associated vaginitis and cervicitis: A prospective and randomized clinical study. Medicine (Baltimore) 2018; 97:e12398. [PMID: 30213012 PMCID: PMC6156011 DOI: 10.1097/md.0000000000012398] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 08/24/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND We evaluated the efficacy and safety of combined high-dose interferon (IFN) and red light therapy for the treatment of subclinical and latent human papillomavirus (HPV) infections. METHODS Ninety women diagnosed with subclinical or latent HPV infection were randomized to receive topical application of low-dose recombinant IFNα-2b (1 million IU), high-dose IFNα-2b (9 million IU), or a combination of high-dose IFNα-2b and red light therapy on the cervix and vagina. All patients received treatment once daily for 4 weeks. HPV titer was measured immediately and 4, 8, and 12 weeks after treatment to determine the rates of viral clearance and infection cure. Treatment of HPV-associated vaginitis and cervicitis was also evaluated. RESULTS Results showed that immediately and 4, 8, and 12 weeks after treatment, the HPV clearance rates and infection cure rates were higher in the high-dose IFN and combination groups compared to the low-dose IFN group. High-dose IFN and combination therapies were significantly effective against both low-risk and high-risk HPV infections. Although the cure rates for vaginitis and cervicitis were significantly higher in the high- compared to the low-dose IFN group, rates were even higher in the combination group compared to the high-dose IFN group. Mild adverse effects were reported by a very small subset of patients (3/30) in the combination group. CONCLUSIONS This study suggests that combination of high-dose IFN and red light therapy is safe and effective against subclinical and latent HPV infections.
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Affiliation(s)
- Hui-Juan Shi
- Department of Dermatovenereology, Ningxia Medical University General Hospital, Yinchuan
| | - Hongbin Song
- Department of Dermatology, Chinese PLA General Hospital, Beijing
| | - Qian-Ying Zhao
- Medical Experimental Center, Ningxia Medical University General Hospital
| | - Chun-Xia Tao
- Department of Dermatovenereology, Ningxia Yangguang Hospital, Yinchuan, China
| | - Min Liu
- Department of Dermatovenereology, Ningxia Medical University General Hospital, Yinchuan
| | - Qin-Qin Zhu
- Department of Dermatovenereology, Ningxia Yangguang Hospital, Yinchuan, China
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21
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Ao C, Xie J, Wang L, Li S, Li J, Jiang L, Liu H, Zeng K. 5-aminolevulinic acid photodynamic therapy for anal canal condyloma acuminatum: A series of 19 cases and literature review. Photodiagnosis Photodyn Ther 2018; 23:230-234. [PMID: 30224029 DOI: 10.1016/j.pdpdt.2018.06.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anal canal condyloma acuminata are common, sexually transmitted lesions, most often caused by the human papillomavirus. The relatively high recurrence rate of anal canal condyloma acuminata can be attributed to the unsuccessful elimination of viruses in areas of subclinical and latent infection. This study aimed to observe and evaluate the effectiveness of 5-aminolevulinic acid-photodynamic therapy combined with monitoring of human papillomavirus load changes in patients with anal canal condyloma acuminata. METHODS A total of 19 patients with anal genital warts were recruited for this study. Firstly, visible warts around the anus were removed. Next, an anoscope examination was performed. Human papillomavirus detection, using real-time polymerase chain reaction assays, was performed before every cycle of treatment. Absorbent cotton rolls soaked with a concentration of 20% 5-aminolevulinic acid were inserted into the anus for 3 h. Finally, photodynamic therapy was applied to the lesions. Each patient required multiple PDT sessions to achieve complete response. RESULTS All patients achieved complete clinical remission one week after the last session of treatment, and human papillomavirus loads decreased significantly. Six months follow-up after completion of therapy, none of the patients had recurrence. CONCLUSIONS 5-aminolevulinic acid-photodynamic therapy is an effective and safe approach for anal canal condyloma acuminata. Dynamic human papillomavirus viral quantitative monitoring can aid in the evaluation of therapeutic effects and lead to better treatment outcomes.
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Affiliation(s)
- Chunping Ao
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Jiajia Xie
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Li Wang
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Songshan Li
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Junpeng Li
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Lifen Jiang
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Hui Liu
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
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Wu MF, Wang B, Lv T, Miao F, Zhang JC, Wang HW. Successful treatment of penile condyloma acuminata accompanied with lichen planus with photodynamic therapy. Photodiagnosis Photodyn Ther 2018; 24:142-144. [PMID: 30063988 DOI: 10.1016/j.pdpdt.2017.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 08/27/2017] [Accepted: 09/05/2017] [Indexed: 10/28/2022]
Abstract
Condyloma acuminata and lichen planus are different cutaneous diseases with disparate etiologies. Simultaneous appearance of two diseases in the same area is rare. This report aims to share the clinical and pathological features of a rare case; introduce an effective and safe therapy of it so as to broaden the therapeutic spectrum of Photodynamic Therapy (PDT) indications.
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Affiliation(s)
- Min-Feng Wu
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Bo Wang
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200225, PR China
| | - Ting Lv
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Fei Miao
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Jie-Chen Zhang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China
| | - Hong-Wei Wang
- Department of Dermatology, Huadong Hospital, Fudan University, Shanghai 200040, PR China.
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Effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum. Photodiagnosis Photodyn Ther 2017; 18:310-314. [PMID: 28300722 DOI: 10.1016/j.pdpdt.2017.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/23/2017] [Accepted: 03/09/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The effect of 5-aminolevulinic acid photodynamic therapy on keratinocyte proliferation and apoptosis in condyloma acuminatum tissues was evaluated. METHODS An immunohistochemical method and TdT-mediated dUTP nick end labeling were performed to detect the positive expression of the keratinocyte proliferation-related gene Ki-67 and apoptosis, respectively, in condyloma acuminatum tissues. RESULTS Of 52 cases, 44 showed positive expression of Ki-67 in condyloma acuminatum keratinocytes before the treatment, with a positive expression rate of 84.62% (44/52), an expression strength of mostly ++ - +++, and a Ki-67 proliferation index of 80.26±5.07%. After treatment, 22 cases showed positive expression of Ki-67 in condyloma acuminatum keratinocytes, with a positive expression rate of 42.31% (22/52), an expression strength of mostly - - ++, and a proliferation index of 42.67±3.06%. The differences in the positive expression rate, expression strength, and proliferation index in the before- and after-treatment groups were statistically significant (χ2=20.070, P<0.001). For visible apoptotic cells in condyloma acuminatum keratinocytes before the 5-aminolevulinic acid photodynamic treatment, the expression strength was mostly + - ++, and the average apoptotic index was 13.94±2.35%; after treatment, the expression strength was mostly ++ - +++, and the average apoptotic index was 73.88±7.65%; the difference in the apoptotic index between the before and after treatment groups was statistically significant (P<0.001). CONCLUSION 5-Aminolevulinic acid photodynamic therapy can inhibit the proliferation and promote the apoptosis of keratinocytes, and represents an effective mechanism for treating condyloma acuminatum.
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Li Q, Jiao B, Zhou F, Tan Q, Ma Y, Luo L, Zhai J, Luan Q, Li C, Wang G, Gao T. Comparative study of photodynamic therapy with 5%, 10% and 20% aminolevulinic acid in the treatment of generalized recalcitrant facial verruca plana: a randomized clinical trial. J Eur Acad Dermatol Venereol 2013; 28:1821-6. [PMID: 24267796 DOI: 10.1111/jdv.12319] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 10/11/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Generalised recalcitrant facial verruca plana responds poorly to current therapeutic options, including cryotherapy, topical drugs and carbon dioxide (CO2 ) laser. Case reports and uncontrolled studies suggested that topical photodynamic therapy (PDT) is effective choice of treatment free from potential complications associated with invasive therapies. AIMS To investigate the efficacy and safety of PDT with different concentrations of photosensitiser in the treatment of verruca plana. MATERIALS & METHODS The two sides of a subject's face were separately randomized to receive aminolevulinic acid (ALA) of 5%, 10% or 20% concentration. All patients were irradiated with 633-nm red light for 339 J/cm(2) total dose. Complete response (CR) rate was assessed on Week 4, 8, and 16 respectively. RESULTS The mean overall clearance rate was 74.1%, 68.8%, and 64.6% on Week 4, 8, and 12, respectively, in the 110 treated sides. The CR rate was lower in the 5%-ALA group than in the 10%-ALA group (14.3% vs. 33.3%, p < 0.05) and 20%-ALA group (14.3% vs. 26.3%, p < 0.05) after 12 weeks. The mean severity of pain measured by visual analogue scale (VAS) scoring was 3.8 (range: 2 to 10, depending on the lesion location). The overall recurrence rate was 16.7% (4/24) on Week 12. Hyperpigmentation was observed in 61% (67/110) of all treated sides. On Week 4, 8, and 16, hyperpigmentation was more developed in the 20%-ALA group than in the other two groups (p < 0.05). DISCUSSION In terms of complete clearance rate, the 5% ALA-PDT group was significantly inferior to the 10% and 20% ALA-PDT groups at each follow-up. In contrast, the 20% ALA group showed a higher incidence rate of transient hyperpigmentation than the other two groups. CONCLUSIONS This randomised clinical trial suggests that PDT with ALA of 10% concentration offers better efficacy and safety than 5% or 20% concentration for generalised recalcitrant facial verruca plana.
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Affiliation(s)
- Q Li
- Department of Dermatology at Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Wang HW, Lv T, Zhang LL, Lai YX, Tang L, Tang YC, Huang Z, Wang XL. A prospective pilot study to evaluate combined topical photodynamic therapy and surgery for extramammary paget's disease. Lasers Surg Med 2013; 45:296-301. [PMID: 23740664 DOI: 10.1002/lsm.22142] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Hong-wei Wang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
- Department of Dermatology; Shanghai Huadong Hospital; Shanghai P.R. China
| | - Ting Lv
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
- Department of Dermatology; Shanghai Huadong Hospital; Shanghai P.R. China
| | - Ling-lin Zhang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
| | - Yong-xian Lai
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
| | - Li Tang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
| | - Yi-chen Tang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
| | - Zheng Huang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
- University of Colorado Cancer Center; Aurora Colorado
| | - Xiu-li Wang
- Department of Dermatology and Venereology; Shanghai Skin Diseases Hospital; 200 Wuyi Road Shanghai P.R. China
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Li X, Wang X, Gu J, Ma Y, Liu Z, Shi Y. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of condylomata acuminata. Exp Ther Med 2013; 6:236-240. [PMID: 23935753 PMCID: PMC3735532 DOI: 10.3892/etm.2013.1092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/19/2013] [Indexed: 12/02/2022] Open
Abstract
The external application of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT) results in a shallow penetration depth in thick or extensive condylomata acuminata (CA) lesions, thus demonstrating a poor therapeutic effect for those patients. To compare the efficacy of needle-free injection with external application of ALA in PDT for the treatment of CA, 160 CA patients with thick or extensive warts received ALA-PDT by means of external application or needle-free injection of ALA, respectively. The complete response (CR) rate and recurrence rate in the two groups were analyzed. The CR rate after the first treatment in the needle-free injection group (68.8%) was significantly higher compared with that in the external application group (52.5%; P=0.035). The recurrence rates in the needle-free injection group and external application group were 4.1 and 15.4%, respectively (P=0.022). The needle-free injection of ALA increases the therapeutic effect of PDT for CA patients with thick or extensive lesions. It shortens the treatment time and reduces the recurrence rate, and has great potential in the treatment of CA.
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Affiliation(s)
- Xiuli Li
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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27
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Wang HW, Zhang LL, Miao F, Lv T, Wang XL, Huang Z. Treatment of HPV infection-associated cervical condylomata acuminata with 5-aminolevulinic acid-mediated photodynamic therapy. Photochem Photobiol 2012; 88:565-9. [PMID: 22150321 DOI: 10.1111/j.1751-1097.2011.01060.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate the efficacy of 5-aminolaevulinic acid (ALA)-mediated photodynamic therapy (PDT) in treatment of human papillomavirus (HPV)-associated cervical condylomata. A total of 56 patients with cervical and external condylomata lesions were recruited for this open-label study. HPV genotyping of exfoliated cells collected from the cervix and external lesions was performed. Cervical lesions were treated with PDT by applying ALA gel (10%) to the surface of the cervix for 4 h followed by irradiating with a 635 nm laser at 100 J cm(-2). PDT was repeated at 2-week intervals if lesion and HPV infection remained. Patients were followed up for 6-24 months. Genotyping analysis revealed four HPV subtypes (HPV6, 11, 16 and 18). The overall complete remission rate of 1-4 sessions of treatments was 98.2% and the corresponding HPV clearance rate was 83.9%. Ten cases showed complete removal of cervical lesions and HPV infection after a single treatment. Recurrence rate was 3.6%. Adverse effects were minimal and no structural complications were reported. In conclusion, topical ALA PDT is safe and effective for eradicating cervical HPV infection and eliminating condylomata lesion. Its definitive role in treating cervical condylomata deserves further investigation.
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Affiliation(s)
- Hong-Wei Wang
- Department of Dermatology and Venereology, Shanghai Skin Diseases Hospital, Shanghai, China
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Lu YG, Yang YD, Wu JJ, Lei X, Cheng QH, He Y, Yang W. Treatment of perianal condyloma acuminate with topical ALA-PDT combined with curettage: outcome and safety. Photomed Laser Surg 2011; 30:186-90. [PMID: 22047599 DOI: 10.1089/pho.2011.3040] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the treatment outcome and safety of topical photodynamic therapy (PDT) with aminolevulinic acid (5-ALA) combined with surgical curettage for perianal condyloma acuminata. BACKGROUND DATA Condyloma acuminata is the most common sexually transmitted disease, with a high relapse rate, especially in the perianal area. The outcomes of many treatment methods for perianal genital warts are not satisfactory. METHODS In this study, 40 cases of perianal condyloma acuminata were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) combined with curettage. First, the warts were removed with the patient under local anesthesia. The depth of the ablation and curettage reached the dermal layer. Then, the first session of PDT was performed after 2 days. Ten percent 5-ALA cream was applied to lesional skin with occlusive dressing for a 3-h incubation period and the lesions of warts were irradiated for 10 min by using a 635-nm laser beam of 177 mW/cm(2) intensity. The ALA-PDT was repeated after 1 and 3 weeks. Follow-up evaluation was performed at our outpatient clinic at 1 and 3 months after completion of therapy. Before treatment and at each follow-up visit, the lesions were photographed; the treatment outcome was evaluated as recurrence rate, and patient satisfaction was surveyed. RESULTS After three PDT sessions following surgical curettage, all 40 patients were cured and there was no recurrence at 1 month off treatment. At 3 months off treatment, six cases relapsed, corresponding to a recurrent rate of 15%. The satisfaction rate of patients was 100% at 1 month and 95% at 3 months after treatment. CONCLUSIONS Combination of surgical curettage and topical PDT has been proven to be a safe and effective procedure, and may offer a wide clinical application for the treatment of perianal condyloma acuminata.
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Affiliation(s)
- Yuan-gang Lu
- Plastic and Cosmetic Surgery Department, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
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Inada NM, Costa MMD, Guimarães OCC, Ribeiro EDS, Kurachi C, Quintana SM, Lombardi W, Bagnato VS. Photodiagnosis and treatment of condyloma acuminatum using 5-aminolevulinic acid and homemade devices. Photodiagnosis Photodyn Ther 2011; 9:60-8. [PMID: 22369730 DOI: 10.1016/j.pdpdt.2011.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 09/01/2011] [Accepted: 09/01/2011] [Indexed: 12/29/2022]
Abstract
BACKGROUND The objective of this study was to improve the feasibility of applying topic 5-aminolevulinic acid (ALA) in photodiagnosis (PD) and treatment of condyloma caused by human papillomavirus (HPV) using two homemade handheld devices and to discuss the photodynamic therapy (PDT) as a suitable alternative for each of the cases studied. Both, protoporphyrin IX production and photodegradation were analyzed, and the pain experienced during the illumination was correlated with the light intensities. METHODS A total of 40 women with different grades of lesions caused by HPV were chosen from patients of the School of Medicine of Ribeirão Preto (University of Sao Paulo) and of the Unit of Public Health of Araraquara, Sao Paulo. RESULTS We did not encounter any unexpected difficulties using our devices during the treatment. The existence of an easily observable reddish fluorescence with large intensity concentrated on the lesions is the clinical indication of the penetration and the selective concentration of protoporphyrin IX in the clinical and subclinical lesions rather than in the healthy tissue. The aesthetic results were much better than those obtained by conventional techniques as surgery or cryogenics, with no recurrence reported after two years of treatment. CONCLUSIONS Our results are proof for the various advantages using ALA cream for the PD and PDT in many different cases of condyloma by HPV. This study will be continued to investigate the PpIX photobleaching and the irradiance and fluence rate to optimize conducting the clinical trials, to improve the devices and therefore increase the treatment response.
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Affiliation(s)
- Natalia Mayumi Inada
- Instituto de Física de São Carlos (IFSC/USP), Laboratório de Biofotônica, São Carlos, São Paulo, Brazil.
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Harris F, Pierpoint L. Photodynamic therapy based on 5-aminolevulinic acid and its use as an antimicrobial agent. Med Res Rev 2011; 32:1292-327. [PMID: 21793017 DOI: 10.1002/med.20251] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Exogenous 5-aminolevulinic acid (ALA) is taken up directly by bacteria, yeasts, fungi, and some parasites, which then induces the accumulation of protoporphyrin IX (PPIX). Subsequent light irradiation of PPIX leads to the inactivation of these organisms via photodamage to their cellular structures. ALA uptake and light irradiation of PPIX produced by host cells leads to the inactivation of other parasites, along with some viruses, via the induction of an immune response. ALA-mediated PPIX production by host cells and light irradiation result in the inactivation of other viruses via either the induction of a host cell response or direct photodynamic attack on viral particles. This ALA-mediated production of light-activated PPIX has been extensively used as a form of photodynamic therapy (PDT) and has shown varying levels of efficacy in treating conditions that are associated with microbial infection, ranging from acne and verrucae to leishmaniasis and onychomycosis. However, for the treatment of some of these conditions by ALA-based PDT, the role of an antimicrobial effect has been disputed and in general, the mechanisms by which the technique inactivates microbes are not well understood. In this study, we review current understanding of the antimicrobial mechanisms used by ALA-based PDT and its role in the treatment of microbial infections along with its potential medical and nonmedical applications.
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Affiliation(s)
- Frederick Harris
- School of Forensic and Investigative Sciences, University of Central Lancashire, Preston, Lancashire, United Kingdom. fharris1@.ac.uk
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Mi X, Chai W, Zheng H, Zuo YG, Li J. A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2011; 27:176-80. [DOI: 10.1111/j.1600-0781.2011.00592.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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