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Prayogo SA, Andrew H, Cong S, Intaran KDA. Photodynamic therapy in the treatment of condyloma acuminata: A systematic review of clinical trials. Int J STD AIDS 2023; 34:76-86. [PMID: 36420589 DOI: 10.1177/09564624221138351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Condylomata acuminata (CA) is a sexually transmitted infection with a high prevalence associated with psychosexual morbidity in both men and women of various age. Up to now, treatment modalities yield low clearance and recurrence rate (RR) and are also deemed low quality evidence-wise. Photodynamic therapy (PDT) is a novel and promising therapy to effectively cure and prevent CA recurrence. METHOD This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and registered to the International Prospective Register of Systematic Review (PROSPERO) (CRD42022332760). RESULTS Ten studies were included in this systematic review. A significant value of complete response (CR) ranging from 63-100% in patients with genital warts after receiving several sessions of PDT. A relatively low recurrence rate was seen in all 10 studies, with an RR of less than 17%. Quality assessment of included studies reported mostly high-quality research. CONCLUSIONS PDT therapy resulted in a higher CR with significantly lower RR compared to other therapies. Thus, PDT can be an alternative treatment of CA with low RR and minimal side effects. Additional research, especially randomized clinical trials in various countries, is needed to further substantiate this treatment and formulate definitive protocols.
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Affiliation(s)
| | - Hubert Andrew
- Faculty of Medicine, 64733Universitas Indonesia, Jakarta Pusat, Indonesia
| | - Stefanny Cong
- Faculty of Medicine, 64733Universitas Indonesia, Jakarta Pusat, Indonesia
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Chang R, Zhang Y, Liu Y, Jiang F, Zhang S, Zhang C. 5-aminolevulinic acid photodynamic therapy combined with wart curettage treatment for intractable urethral condylomata acuminata. A case report. Photodiagnosis Photodyn Ther 2022; 41:103264. [PMID: 36587864 DOI: 10.1016/j.pdpdt.2022.103264] [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: 09/29/2022] [Revised: 12/08/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
Condylomata acuminata (CA) is caused by human papillomavirus (HPV). It is one of the most common sexually transmitted diseases (STD). The lesions mainly occur in the external genitalia and perianal areas, rarely involves in urethral and usually localized at the distal 3 cm of the urethral orifice. Because of the special anatomical site, treating urethral CA is challenging and it has high recurrence rate after treatment. 5-aminolevulinic acid photodynamic therapy (ALA-PDT) can successfully treat urethral CA, however, the experience of using ALA-PDT combined with wart curettage to treat intractable urethral CA is still very limited. In here, we reported an intractable urethral CA case with effective remission after receiving combination therapy. Wart curettage combine with ALA-PDT is an expeditious, economical, and well-tolerated treatment method.
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Affiliation(s)
- Ruixue Chang
- Department of Dermatology and Venereology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Yuanjing Zhang
- Department of Dermatology and Venereology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Yixun Liu
- Department of Urological surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Faxing Jiang
- Department of Dermatology and Venereology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Siping Zhang
- Department of Dermatology and Venereology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Chi Zhang
- Department of Dermatology and Venereology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China.
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Wu C, Qiu X, He C, Ci C. Effect of 5-Aminolevulinic Acid Photodynamic Therapy with Transfer Factor Capsules in the Treatment of Multiple Plantar Warts. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1220889. [PMID: 36425335 PMCID: PMC9681558 DOI: 10.1155/2022/1220889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 10/29/2023]
Abstract
BACKGROUND Plantar warts are a common cutaneous disease of the sole of the foot caused by human papillomavirus. Photodynamic therapy has gained increasing attention in the treatment of plantar warts. OBJECTIVE To investigate the effect of photodynamic therapy combined with transfer factor capsules in the treatment of multiple plantar warts. METHODS Sixty-one patients with multiple plantar warts who visited our outpatient department from September 2017 to August 2019 were randomly divided into two groups. Twenty-three patients received photodynamic therapy (treatment group) and thirty-eight received cryotherapy (control group). Both groups also received immune modulator transfer factor capsules. Skin lesion score, numeric rating scale- (NRS-) 10 score, recurrence rate, adverse reactions, and Dermatology Life Quality Index (DLQI) were analyzed in both groups. RESULTS The mean skin lesion score improved from 13.39 ± 3.88 before treatment to 1.48 ± 2.50 after the last treatment in the treatment group and from 12.47 ± 2.99 before treatment to 4.47 ± 3.67 after the last treatment in the control group. The success rate after 3 months of treatment was 86.96% in the treatment group and 39.47% in the control group. After 3 months of follow-up, the recurrence rate was significantly lower in the treatment group (20%) than in the control group (53.33%). The mean DLQI score at three months after treatment was significantly lower in the treatment group (3.61 ± 1.16) than in the control group (6.31 ± 2.59). CONCLUSION Photodynamic therapy combined with immunomodulators significantly increased the cure rate and reduced the recurrence rate of multiple plantar warts compared with traditional cryotherapy combined with immunomodulators.
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Affiliation(s)
- Chen Wu
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Xiamin Qiu
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Caifeng He
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
| | - Chao Ci
- Department of Dermatology, Yijishan Hospital of Wannan Medical College, No. 2 Zheshan West Road, Wuhu, Anhui 241001, China
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[Translated article] Refractory Anogenital Warts: Good Response to Photodynamic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pinilla Martín B, Rivera Díaz R, Monsálvez Honrubia V. Condilomas acuminados resistentes a los tratamientos convencionales con buena respuesta a tratamiento con terapia fotodinámica. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:210-212. [DOI: 10.1016/j.ad.2020.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/23/2020] [Accepted: 08/19/2020] [Indexed: 10/20/2022] Open
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Pinilla Martín B, Rivera Díaz R, Monsálvez Honrubia V. WITHDRAWN: Refractory Anogenital Warts: Good Response to Photodynamic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Clinical Efficacy of Carbon Dioxide Laser Combined with ALA Photodynamics in the Treatment of Condyloma Acuminatum. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:7211055. [PMID: 34707674 PMCID: PMC8545531 DOI: 10.1155/2021/7211055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022]
Abstract
'Purpose. To observe the clinical efficacy and safety of carbon dioxide laser combined with ALA photodynamics in the treatment of condyloma acuminatum. Method. A total of 211 patients with condyloma acuminatum admitted to our hospital from April 2018 to June 2021 were selected as the observation object. They were divided into the intervention group (CO2 laser combined with ALA photodynamic therapy, 125 cases) and conventional group (CO2 laser treatment, 86 cases), and the efficacy and incidence of adverse reactions between the two groups were compared. Result. The total effective rate of the intervention group (96.00%) was significantly higher than that of the conventional group (84.88%) (P < 0.05). The total incidence of adverse reactions in the intervention group (8.00%) was lower than that in the conventional group (32.56%) (P < 0.05). Univariate analysis showed that the patient's smoking history, drinking history, course of disease, wart area, and number of sexual partners were related to the short-term prognosis (P < 0.05). Multivariate logistic regression analysis showed that the patient's course of disease, the area of the wart body, and the number of sexual partners were independent factors affecting the prognosis of patients with condyloma acuminatum (P < 0.05). Conclusion. Carbon dioxide laser combined with ALA dynamics treatment of condyloma acuminatum significantly improves the clinical efficacy, does not increase the incidence of adverse reactions, and has important clinical therapeutic value. The course of the disease, the area of the wart, and the number of sexual partners are independent factors affecting the prognosis of patients with condyloma acuminatum.
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Liu D, Zhao S, Li J, Chen M, Wu L. The application of physical pretreatment in photodynamic therapy for skin diseases. Lasers Med Sci 2021; 36:1369-1377. [PMID: 33404884 DOI: 10.1007/s10103-020-03233-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023]
Abstract
Photodynamic therapy (PDT) is widely used in skin diseases; the response rate of PDT treatment varies widely. The limited penetration in the tissue of photosensitizers influenced the penetration depth of PDT, which obviously impacts the therapeutic effect. The studies have improved the efficacy of PDT through various pretreatment applications; especially, the physical pretreatment had achieved significant outcomes. We will review the physical pretreatment to optimize the efficacy of PDT in skin diseases by searching the literature on this topic. The types of physical pretreatment commonly used in the clinical practice are discussed: curettage, superficial shaving, laser, surgical resection, plum-blossom needles, and microneedles. Compared with PDT alone, the physical pretreatment before PDT application was generally improved the efficacy and reduced the recurrence, especially in actinic keratoses (AK), Bowen disease (BD), basal cell carcinoma (BCC), and viral warts. The application of the physical pretreatments before PDT may improve the efficacy of PDT in various skin diseases. However, each kind of physical pretreatment has the benefit and shortcoming, and the applicable situation is different.
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Affiliation(s)
- Dihui Liu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.,Department of Dermatology, Guangzhou Integrated Traditional Chinese and Western Medicine Hospital, 87 Yingbin Avenue, Huadu District, Guangzhou, 510800, Guangdong, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Jinmao Li
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Lisha Wu
- Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,Institute of Medical Sciences, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China. .,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Liao C, Sun X, Zhang G, Zhang H, Zhang L, Wang X. Advanced application of holmium: YAG laser combined ALA-PDT for the treatment of refractory condylomata acuminata in anal canal. Photodiagnosis Photodyn Ther 2020; 30:101696. [PMID: 32109616 DOI: 10.1016/j.pdpdt.2020.101696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/10/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anal canal condylomata acuminata is a disease caused by the human papilloma virus. Conventional cauterizing laser treatment cannot achieve a satisfactory result owing to a high recurrence rate, and the application of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) also has limitations in the anal canal. Holmium yttrium aluminum garnet (Ho: YAG) laser with fiber is found to be effective at removing canal lesions, and may create suitable conditions for ALA-PDT. We aim to investigate the feasibility of Ho: YAG laser combined with ALA-PDT and to explore a more optimal therapy in refractory anal canal condylomata. METHODS Data of 37 patients with anal canal condylomata (number of warts≥ 10 lesions) from May 2017 to March 2019 were reviewed. In total 17 cases were treated with Ho: YAG laser plus ALA-PDT, and 20 patients treated with CO2 laser plus ALA-PDT were selected as control. Wart clearance and recurrence rates were evaluated as well as laser complications. RESULTS Most warts (88.23 %) were removed after a session of Ho: YAG laser pretreatment. The average number of laser sessions required to clear all warts was 1.94 in the Ho: YAG laser plus ALA-PDT group. Meanwhile, no wound infections or defecation disfunctions were found. Ho: YAG laser with ALA-PDT could significantly reduce wart recurrence rates (17.6 %) in comparison with CO2 laser with ALA-PDT (55 %). CONCLUSIONS Ho: YAG laser combined with ALA-PDT raised the cure rate of refractory anal canal condylomata and has important guidance implications for clinical application.
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Affiliation(s)
- Caihe Liao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Xiaofei Sun
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
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Wang J, Li S, Li J, Li Z, Wang Q, Peng X, Shi M, Che Q, Liu H, Jiang L, Zeng K. Evaluation of human papillomavirus DNA detection-guided aminolaevulinic acid-mediated photodynamic therapy for the treatment of condyloma acuminata. Photodiagnosis Photodyn Ther 2019; 28:114-119. [PMID: 31479803 DOI: 10.1016/j.pdpdt.2019.08.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/24/2019] [Accepted: 08/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) is used to treat condyloma acuminata (CA), yielding a high clearance rate and low recurrence rate. Consecutive human papillomavirus (HPV) DNA detection can be used to dynamically monitor the therapeutic efficiency of PDT. Here, we evaluated the efficacy of ALA-PDT in the context of different HPV infection states. METHODS One hundred thirty-eight patients with HPV infection and visible anogenital warts were enrolled. Microwave or radiofrequency was used to remove visible lesions before PDT. HPV DNA detection was performed using real-time polymerase chain reaction before each PDT session and at follow-up. Treatment was halted after the patient showed two negative results for HPV DNA detection in a row. RESULTS Of the 138 patients enrolled in the study, 72 completed treatment. Multisite HPV-infected patients required more sessions of PDT than did single-site infected patients to reach the endpoint of treatment. Compared with patients with only external CA, individuals with internal CA required more sessions to eliminate HPV infection. The total number of PDT sessions performed in the multitype HPV-infected group was significantly higher than that in the single-type infected group. Patients with non-high-risk (HR)-HPV infection required fewer PDT sessions than did those with HR-HPV infection by the end of treatment. Sixty-nine patients were followed-up for at least 6 months, only 2.9% of whom showed recurrence. CONCLUSIONS Combined ALA-PDT and HPV DNA detection was an effective strategy for the treatment of CA. Patients with multisite and multitype HPV infection required more PDT sessions to eliminate the virus.
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Affiliation(s)
- Jingying 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.
| | - Zhijia Li
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Qi Wang
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Xiaoming Peng
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Minglan Shi
- Department of Dermatology and Venereology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
| | - Qilei Che
- 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.
| | - Lifen Jiang
- 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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Nguyen K, Khachemoune A. An update on topical photodynamic therapy for clinical dermatologists. J DERMATOL TREAT 2019; 30:732-744. [DOI: 10.1080/09546634.2019.1569752] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Khoa Nguyen
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, Brooklyn, NY, USA
- Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
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Mahmoudi H, Ghodsi S, Tavakolpour S, Daneshpazhooh M. Cryotherapy plus oral zinc sulfate versus cryotherapy plus placebo to treat common warts: A double blind, randomized, placebo-controlled trial. Int J Womens Dermatol 2018; 4:87-90. [PMID: 29872682 PMCID: PMC5986231 DOI: 10.1016/j.ijwd.2017.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/11/2017] [Accepted: 09/18/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cutaneous warts are caused by a small group of specific types of human papillomaviruses. Cryotherapy is a highly effective treatment for patients with viral warts; however, it is a painful method and usually requires several treatment sessions. Zinc is a trace element with many proven effects on the immune system. OBJECTIVE Our aim was to assess the efficacy and safety of oral zinc sulfate in the treatment and recurrence rate of common warts. METHODS Eighty-three patients with common warts participated in this double-blind, randomized, placebo-controlled trial. In both groups, three sessions of liquid nitrogen cryotherapy were performed for up to 2 months with 3-week intervals. The treatment group (n = 45) received oral zinc sulfate capsules in a dose of 10 mg/kg per day up to 600 mg day. The control group (n = 38) was provided with placebo of similar appearance. Treatment continued for 2 months and the follow-up period lasted up to 6 months. RESULTS Warts completely resolved in 26 patients in the treatment group (68.4%) and 23 patients in the placebo group (63.9%; p = .68). Three patients (7.9%) in the treatment group and six patients (16.6%) in the placebo group has a recurrence of the warts (p = .19). CONCLUSION According to our study, the addition of zinc to cryotherapy was not beneficial in the treatment of patients with common warts nor did it prevent recurrences.
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Affiliation(s)
- H. Mahmoudi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S.Z. Ghodsi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Tavakolpour
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Daneshpazhooh
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
During their lifetime, at least 10 % of the population will be infected by human papillomaviruses (HPV), clinically characterized by the formation of cutaneous or genital warts. Although warts are ubiquitous, there are no defined treatments. Especially in the first six months, warts frequently resolve without therapeutic intervention. This complicates the interpretation of study data, given that many studies do not differentiate between newly infected patients and those with infections that have persisted for a long time. Similarly, most studies do not take location, size, and thickness of lesions into account, either. The objective of the present review article is to analyze the study data currently available, taking into consideration both subtypes and locations - factors exceedingly crucial in clinical practice. In particular, the distinction between new-onset and chronic recalcitrant warts is reflected in a therapeutic algorithm. In the case of genital warts, the algorithm is more clearly determined by the extent of the area affected rather than the longevity of lesions. In immunocompetent individuals, any therapeutic intervention must be aimed at achieving complete resolution.
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Hu YE, Dai SF, Wang B, Qu W, Gao JL. Therapeutic effects of topical 5-aminolevulinic acid photodynamic therapy. Pak J Med Sci 2016; 32:961-4. [PMID: 27648048 PMCID: PMC5017111 DOI: 10.12669/pjms.324.9634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: To evaluate the therapeutic effects of combined 5-aminolevulinic acid (ALA) and photodynamic therapy (PDT) on genital warts and the safety. Methods: One hundred ten patients with genital warts who were treated in our hospital from June 2013 to October 2014 were selected. The warts and affected parts were disinfected with benzalkonium bromide solution, and the warts were covered with absorbent cotton that had already been added freshly prepared 20% ALA solution, packaged and fixed. Then they were wet-dressed in dark, into which ALA solution was added according to the proportion of 5:3:2 every 30 minutes for three consecutive hours. Afterwards, the warts were illuminated by using photodynamic laser apparatus. The clinical outcomes, adverse reactions and recurrence rates were observed. Results: Genital warts were relieved in 107 out of the 110 cases (cure rate: 97.3%). Male patients had significantly better treatment outcomes at the urethral orifice than those in other affected parts. In the 107 patients, the cure rate of male patients was 98.8%, and they were cured after being treated four times. In contrast, female patients, who were cured after 5 times of treatment, had the cure rate of 91.7%. Their cure rates were similar (χ2=0, P>0.05), but the males were cured after significantly fewer times of treatment than the females (t=-7.432, P<0.05). Five patients suffered from mild tingling or burning sensation upon dressing at the urethral orifice, and the others were all free from systemic adverse reactions. After illumination, a small portion of the patients had mildly red, swelling, painful affected parts, with mild edema that almost disappeared within three days. Three patients relapsed at the urethral orifice and were then cured after further treatment. Conclusion: ALA-PDT can treat genital warts safely with high cure rate and low recurrence rate, particularly working for those of males at the urethral orifice.
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Affiliation(s)
- Yin-E Hu
- Yin-E Hu, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China
| | - Shu-Fang Dai
- Shu-Fang Dai, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China
| | - Bin Wang
- Bin Wang, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China
| | - Wei Qu
- Wei Qu, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China
| | - Jun-Ling Gao
- Jun-Ling Gao, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China
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Ockenfels HM. Therapeutisches Management kutaner und genitaler Warzen. J Dtsch Dermatol Ges 2016; 14:892-900. [DOI: 10.1111/ddg.12838_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zhou C, Sun B, Wang F, Dai Z, Han Z, Han J, Chen M, Shen Y. Coblation plus photodynamic therapy (PDT) for the treatment of juvenile onset laryngeal papillomatosis: case reports. World J Surg Oncol 2014; 12:275. [PMID: 25175485 PMCID: PMC4167150 DOI: 10.1186/1477-7819-12-275] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 08/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In treating juvenile-onset laryngeal papillomatosis, the most difficult aspect is preventing recurrence. After a single treatment, recurrence can begin after as soon as 20 days and the recurrent rate can be higher than 90%. The causes of recurrence include the presence of mucosal cells infected with papilloma virus, which are undetectable with the naked eyes, and surgery-induced infection. Photodynamic therapy (PDT) could effectively solve this problem. Virus-infected cells have a very high metabolic energy for capturing and internalizing the photosensitizer, which, after light stimulation, subsequently induces active oxygen species inside the nucleus, which kill infected cells. The second generation of photosensitizer agents (PA) are locally applied to avoid the intravenous systemic damage caused by first-generation PAs, and this method is widely used for the treatment of genital warts to very good effect. METHODS We used the photodynamic method to treat laryngeal papillomatosis in children and obtained significant efficacy. We followed three juvenile subjects with recurrent laryngeal papillomatosis through a course of treatment (each course includes three PDT sessions), with a follow-up after 6 months. RESULTS The characteristic procedures involve exposing the larynx with a laryngoscope and using low-temperature plasma technology to visualize the tumor resection, as the effects of plasma technology can reduce postoperative laryngeal edema and reduce intraoperative metastasis. PDT was performed during the first surgery, 20 days after and 30 days after surgery. At the 6-month follow-ups, there was no recurrence. CONCLUSION This was the world's first successful reported case of the use of PDT treatment for juvenile laryngeal papillomatosis.
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Affiliation(s)
- Chengyong Zhou
- Department of Otolaryngology, The First Affiliated Hospital of PLA General Hospital, No,51, HaiDian Distric Fu Cheng Road, Beijing 100048, China.
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Christensen ND, Cladel NM, Hu J, Balogh KK. Formulation of cidofovir improves the anti-papillomaviral activity of topical treatments in the CRPV/rabbit model. Antiviral Res 2014; 108:148-55. [PMID: 24946003 DOI: 10.1016/j.antiviral.2014.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 11/26/2022]
Abstract
Current topical treatments for papillomas use ablative, cytotoxic and immunomodulating strategies and reagents. However, the effectiveness of topical treatments using different formulations has not been examined in preclinical models or clinical trials. The purpose of this study was to determine whether formulation of the small molecule acyclic nucleoside, cidofovir (CDV), could lead to improved therapeutic endpoints following topical treatment of papillomas using the cottontail rabbit papillomavirus (CRPV)/rabbit model. Different formulations with a set dose of 1% cidofovir were tested to establish comparative data. The results demonstrated that anti-papilloma treatments with topical CDV were greatly enhanced when formulated versus unformulated. Best results were obtained with CDV formulated in cremophor, then in Carbomer 940, and then in DMSO. Further studies indicated that effective formulations led to complete cures of papillomas at dilutions less than 0.3% CDV. These studies together with previous observations demonstrated that unformulated CDV under the same treatment regime required doses of 2% to achieve cures demonstrating that much less compound can be used when properly formulated.
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Affiliation(s)
- Neil D Christensen
- Department of Pathology, Penn State College of Medicine, Hershey, PA 17033, United States; Department of Microbiology and Immunology, Penn State College of Medicine, Hershey, PA 17033, United States.
| | - Nancy M Cladel
- Department of Pathology, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Jiafen Hu
- Department of Pathology, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Karla K Balogh
- Department of Pathology, Penn State College of Medicine, Hershey, PA 17033, United States
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Shi H, Zhang X, Ma C, Yu N, Wang J, Xia L, Ge X, Liu M, Duan A. Clinical analysis of five methods used to treat condylomata acuminata. Dermatology 2013; 227:338-45. [PMID: 24216675 DOI: 10.1159/000355351] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 08/23/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Treatments for condylomata acuminata (CA) include pharmacotherapy and surgical therapies, but each treatment has its limitations. The aim of this study was to investigate the virus clearance rate, wart cure rate and safety of 5 methods on CA. METHODS 361 patients diagnosed with CA were divided into groups A (<0.5 cm), B (0.5-2.0 cm) and C (>2.0-4.0 cm) according to the maximum diameter of their lesion. Five treatments were compared in each group, and the clinical outcomes were evaluated during follow-ups. RESULTS A 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is preferred if the maximum lesion diameter is <0.5 cm and an ALA-PDT plus cryotherapy treatment is preferred for lesions 0.5-2.0 cm. For lesions >2.0- 4.0 cm, an ALA-PDT retreatment (after cryotherapy or CO2 laser treatment) should be the first choice. CONCLUSIONS The treatments for CA should be chosen according to the maximum diameter of each patient's lesion.
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Affiliation(s)
- Huijuan Shi
- Department of Dermatovenereology, Ningxia Medical University General Hospital, Yinchuan, China
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