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Updated: Aug 14, 2026
An In Vitro Approach to Photodynamic Therapy
Published on: August 17, 2018
Single-episode photodynamic therapy and vulval intraepithelial neoplasia type III resistant to conventional therapy
H A Kurwa1, R J Barlow, S Neill
1Dermatological Surgery and Laser Unit and Vulval Clinic, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH, U.K.
Background:
Photodynamic therapy (PDT) using topical 5-aminolaevulinic acid (5-ALA) has been suggested as an effective and tissue-conserving method of treating carcinoma in situ of the vulva.
Objectives:
To evaluate PDT in patients with vulval intraepithelial neoplasia type III (VIN III).
Methods:
Topical PDT was performed in six patients with VIN III. Five of the six patients had persistent disease following treatment with other modalities including 5-fluorouracil cream, cryotherapy, carbon dioxide laser ablation and excision. Each patient was treated once with a fluence of 150 J cm-2 using a broad-band light source (580-740 nm) 4 h after topical application of 20% 5-ALA. Patients were reviewed clinically at 1 month and 6 months after treatment.
Results:
All of the patients developed initial erythema of treated sites, three with subsequent erosions. All patients had clinically evident persistent VIN III at 1-month review. Five patients have subsequently undergone surgical treatment and one is regularly reviewed.
Conclusions:
This small uncontrolled study indicates that, as currently administered, a single episode of topical PDT is not effective in the management of treatment-resistant VIN III.
