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Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts
Weiming Zhang1, Zhao Jin1, Tingting Gao1
1Department 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.
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.
Insights
Topical 10% 5-aminolevulinic acid photodynamic therapy (ALA-PDT) effectively treated recalcitrant facial flat warts in 86.67% of patients. This safe and well-tolerated treatment offers a promising option for difficult-to-manage human papillomavirus infections.
Area of Science:
- Dermatology
- Photomedicine
- Oncology
Background:
- Photodynamic therapy (PDT) utilizes light energy to activate photosensitizers, generating reactive oxygen species for targeted cell destruction.
- PDT is a promising treatment for human papillomavirus (HPV) infections, including recalcitrant facial flat warts.
- Patients with facial flat warts resistant to conventional therapies seek advanced treatment options.
Purpose of the Study:
- To evaluate the efficacy and safety of topical 10% 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for recalcitrant facial flat warts.
- To assess treatment response rates and recurrence in patients undergoing ALA-PDT.
- To determine the tolerability and adverse effects of ALA-PDT in this patient cohort.
Main Methods:
- Retrospective evaluation of 15 patients with recalcitrant facial flat warts.
- Treatment involved topical 10% ALA-PDT administered every two weeks for two or three sessions.
- Efficacy assessed at 24 weeks post-treatment, monitoring lesion clearance and recurrence.
Main Results:
- Complete or excellent response observed in 86.67% of patients at 24 weeks.
- 100% lesion clearance achieved in 46.67% of patients; 70-100% clearance in 40.00%.
- No disease recurrence or progression reported; adverse reactions were mild and transient.
Conclusions:
- Topical 10% ALA-PDT is a safe and effective therapeutic option for recalcitrant facial flat warts.
- The treatment demonstrates high efficacy and a favorable safety profile for HPV-related lesions.
- ALA-PDT offers a valuable alternative for patients unresponsive to traditional wart treatments.
