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Zhang N, Chen X, Ye T, Ge H, Zhai X, Wu J, Zhang M, Wang M. Successful Treatment of Generalized Facial Verrucae Vulgaris with a Combination of Curettage and Photodynamic Therapy in an Adolescent: A Case Report. Clin Cosmet Investig Dermatol 2024; 17:1695-1699. [PMID: 39071844 PMCID: PMC11278039 DOI: 10.2147/ccid.s470435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
Verrucae vulgaris are highly contagious keratotic lesions occurring on the skin caused by human papillomavirus. Generally, verrucae vulgaris are harmless to the body, but when they occur in specific areas such as the face or soles of the feet, they can profoundly impact an individual's quality of life and necessitate therapeutic intervention. Although several pharmacological and physical topical treatments are available, the results are often unsatisfactory in terms of efficacy and cosmetic outcome. Verrucae which typically occur widely on the face are usually Verrucae Planae. When Verrucae vulgaris does occur, it usually presents as single or occasional multiple lesions, rather than covering almost the entire face. In immunocompromised situations, verruca vulgaris can exhibit rare proliferative behavior. In this report, we present a 17-year-old male adolescent who was successfully treated for generalized facial verrucae vulgaris by using a combination of curettage and photodynamic therapy (PDT). The patient's prolonged use of topical corticosteroids and tacrolimus ointment on the face for eczema over several years is believed to have led to a localized immunosuppressive state of the facial skin, which is considered a significant factor in the outbreak of verrucae vulgaris. Additionally, the patient has a history of acne and frequently scratched face. The appearance of the Koebner phenomenon following scratching is considered another potential reason. This treatment achieved complete resolution and improved the patient's pre-existing acne problem, resulting in a satisfactory cosmetic outcome without any notable adverse effects or recurrence during the follow-up period. This highlighted that pre-treatment with curettage before PDT enhanced the efficiency of verrucae vulgaris treatment and reduced the cost.
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Affiliation(s)
- Na Zhang
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Xinru Chen
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Tianhui Ye
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Hongping Ge
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Xiaoli Zhai
- Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Jun Wu
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Min Zhang
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
| | - Meiyan Wang
- Department of Dermatology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, People’s Republic of China
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Huang Z, Wang F, Liu D, Zhang R. Photodynamic therapy for facial dermatosis papulosa nigra: efficacy and safety in a preliminary study. Photodiagnosis Photodyn Ther 2024:104273. [PMID: 39002830 DOI: 10.1016/j.pdpdt.2024.104273] [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: 06/11/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
Dermatosis papulosa nigra (DPN) is a type of benign epidermal hyperplasia that affects the appearance of patients and poses a threat to their physical and mental health. Photodynamic therapy (PDT) has been shown to have the advantages of non-invasiveness, efficacy, and low recurrence in the treatment of skin disorders. However, no studies have been reported on the use of PDT for the treatment of DPN. Therefore, we used PDT for the first time to treat DPN and monitor its efficacy. Forty-five patients with DPN diagnosed at the outpatient clinic of Changzhou First People's Hospital were treated with 10% 5-aminolevulinic acid (ALA) once a week for four consecutive weeks and followed for 3 months. After four treatment sessions, the cure rate among the 45 patients was 71.1%, and the overall efficacy rate was 93.3%. The most common adverse reactions were mild erythema, edema, and temporary pigmentation. PDT is expected to become a new and effective treatment for DPN.
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Affiliation(s)
- Zeyu Huang
- Department of dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Fang Wang
- Department of dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Danmin Liu
- Department of dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Ruzhi Zhang
- Department of dermatology, The Second Affiliated Hospital of Wannan Medical college,10 Kangfu Road, Wuhu, 241000,China.
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Zhang W, Jin Z, Gao T, Fan L, Wang W, Zeng X, Qin L. Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts. Photodiagnosis Photodyn Ther 2024; 45:103934. [PMID: 38097120 DOI: 10.1016/j.pdpdt.2023.103934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/22/2023]
Abstract
Photodynamic therapy (PDT) uses light energy to excite a photosensitizing agent, leading to production of reactive oxygen species, which exert cytotoxic effects on targeted cells. PDT has emerged as a promising therapeutic modality for the treatment of flat warts caused by human papillomavirus (HPV) infection, by targeting infected keratinocytes and inactivating nonenveloped viral particles. Some patients with recalcitrant flat warts on the face who have poor response to traditional treatment often seek effective therapy to have the warts removed. In this report, we retrospectively evaluated the efficacy of topical 10% 5-aminolevulinic acid PDT (ALA-PDT) in the treatment of 15 patients with recalcitrant facial flat warts. Patients received treatment once every two weeks for a total of two or three sessions. At 24 weeks after the start of treatment, 86.67% of patients showed complete or excellent response. Further more, the remission rate of 100% lesion clearance was 46.67% (seven patients), and the remission rate of 70-100% lesion clearance was 40.00% (six patients). None of the patients experienced disease recurrence or progression. The adverse reactions were generally well tolerated by the patients and mostly resolved in a few days without special treatment. Our findings showed that topical 10% ALA-PDT is a safe and effective treatment for recalcitrant facial flat warts.
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Affiliation(s)
- Weiming Zhang
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China
| | - Zhao Jin
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China
| | - Tingting Gao
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China
| | - Li Fan
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China
| | - Weizhen Wang
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China
| | - Xianyu Zeng
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China.
| | - Li Qin
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Department of Dermatology, Wuhan No.1 Hospital, Wuhan, Hubei 430022, China.
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Lv S, Fu X, Yue Z, Zhang H, Zhou G, Liu H, Zhang F. Photodynamic therapy and CO 2 fractional laser combination therapy for verruca vulgaris caused by Koebner phenomenon - Two case reports. Photodiagnosis Photodyn Ther 2024; 45:103946. [PMID: 38145774 DOI: 10.1016/j.pdpdt.2023.103946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
Verruca vulgaris, caused by the human papillomavirus (HPV), can profoundly impact an individual's quality of life and necessitate therapeutic intervention. The challenges associated with treating verruca vulgaris are particularly noteworthy when they manifest as the Koebner phenomenon (KP). In this report, we present two cases of verruca vulgaris that developed KP following cryotherapy. Some studies have suggested that pretreatment with laser therapy enhances the efficacy of Photodynamic Therapy (PDT). Given the inefficacy of cryotherapy and the emergence of KP in our patients, we opted for a treatment approach that combined PDT with CO2 fractional laser (CO2FL), resulting in complete resolution without any notable adverse effects or recurrence during the follow-up period. Our cases underscore the importance of considering KP when verruca vulgaris exhibit enlargement and proliferation post-cryotherapy. Furthermore, this combined treatment modality demonstrates its effectiveness and safety. Additionally, our experience highlights the need for a large-scale study to determine the optimal photosensitizer concentration for the treatment of thick, enlarged verruca vulgaris.
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Affiliation(s)
- Shuang Lv
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Xi'an Fu
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Zhenhua Yue
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Huimin Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Guizhi Zhou
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Hong Liu
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
| | - Furen Zhang
- Hospital for Skin Diseases, Shandong First Medical University, Jingshi Lu, 27397, Jinan, Shandong Province, China; Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences; Jingshi Lu, 27397, Jinan, Shandong Province, China.
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Zhao SN, Huo W, An Q, Gao TW, Yao ZR, Zhang JZ, Zhang XJ, Gu H, Wu RN, Lu HG, Han XP, Zeng FQ, An RZ, Ma L, Chen HD, Qi RQ, Gao XH. A multi centre real world observation to evaluate the efficacy of cryotherapy versus local hyperthermia for the treatment of plane warts. Dermatol Ther 2022; 35:e15403. [PMID: 35201628 DOI: 10.1111/dth.15403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/20/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Most plane warts are recalcitrant to treatment. Both cryotherapy and local hyperthermia have been applied to treat plane warts. However, no direct comparative study on their respective efficacy and safety has ever been performed. OBJECTIVE To assess the efficacy and safety of local hyperthermia at 43±1°C versus liquid nitrogen cryotherapy for plane warts. METHODS Sequential patients with plane warts entered the study, either receiving cryotherapy or local hyperthermia therapy at the discretion of the patients and the recommendations of consultants. Cryotherapy with liquid nitrogen was delivered in two sessions two weeks apart, while local hyperthermia was delivered on three consecutive days, plus two similar treatments 10 ± 3 days later. The temperature over the treated skin surface was set at 43±1°C for 30 mins in each session. The primary outcome was the clearance rates of the lesions 6 months after treatment. RESULTS Among the 194 participants enrolled, 183 were included in the analysis at 6 months. Local hyperthermia and cryotherapy achieved clearance rates of 35.56% (48/135) and 31.25% (15/48), respectively (p=0.724); recurrence rates of 16.67% (8/48) and 53.33% (8/15) (p=0.01); and adverse events rates of 20.74% (28/135) and 83.33% (40/48), respectively (p<0.001). Cryotherapy had a higher pain score (p<0.001) and a longer healing time (p<0.001). CONCLUSIONS Local hyperthermia at 43°C and cryotherapy had similar efficacy for plane warts. Local hyperthermia had a safer profile than cryotherapy but it required more treatment visits during a treatment course. More patients preferred local hyperthermia due to its treatment friendly nature.
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Affiliation(s)
- Sheng-Nan Zhao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
| | - Wei Huo
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
| | - Qian An
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
| | | | - Zhi-Rong Yao
- Shanghai Jiaotong University, Department of Dermatology, Xinhua Hospital, Shanghai, China
| | | | | | - Heng Gu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ri-Na Wu
- Inner Mongolia Medical University
| | - Hong-Guang Lu
- Affiliated Hospital of Guizhou Medical University, Dermatology, Guiyang, China
| | - Xiu-Ping Han
- Shengjing Hospital of China Medical University, Shenyang, China
| | - Fan-Qin Zeng
- Department of Dermatology, Sun Yat-sen Memorial Hospital of the Sun Yat-sen University, Guangzhou, China
| | - Rong-Zhen An
- Department of Dermatology and Venerology, Affiliated Hospital of Binzhou Medical University, Binzhou, China
| | - Lei Ma
- Department of Dermatology and Venerology, Affiliated Hospital of Binzhou Medical University, Binzhou, China
| | - Hong-Duo Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
| | - Rui-Qun Qi
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China; Key Laboratory of Immunodermatology, Ministry of Health and Ministry of Education, China.,National and Local Joint Engineering Research Centre of Immunodermatological Theranostics, Shenyang, China.,National Engineering Research Center for Immunodermatoloigcal Theranostics, Shenyang, China
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Leerunyakul K, Thammarucha S, Suchonwanit P, Rutnin S. A comprehensive review of treatment options for recalcitrant nongenital cutaneous warts. J DERMATOL TREAT 2020; 33:23-40. [PMID: 32116076 DOI: 10.1080/09546634.2020.1737635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: The treatment of recalcitrant nongenital cutaneous warts has always been challenging for dermatologists as they often recur and relapse. Multiple treatment options have been investigated to improve the outcome. This review provides an overview of the current treatment modalities and summarizes the efficacy and side effects of each treatment option for recalcitrant nongenital cutaneous warts.Methods: A PubMed search was performed through July 2019 to include all English language reports investigating the treatment for recalcitrant nongenital cutaneous warts, regardless of design.Results: A total of 144 studies were included in this review. The treatment options for recalcitrant nongenital cutaneous warts can be divided into three groups: destructive treatment, immunotherapy, and cytotoxic agents. Although both destructive therapies and cytotoxic agents demonstrated high complete response rates, immunotherapy, which is a minimally invasive method, was superior in terms of the clearance of distant warts. Intralesional mumps-measles-rubella injections and purified protein derivatives currently demonstrate high efficacy with well-established clinical evidence.Conclusions: Many upcoming treatment modalities, especially immunotherapy, are promising. However, more comparative studies are required to verify the efficacy and safety profile.
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Affiliation(s)
- Kanchana Leerunyakul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasima Thammarucha
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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