Comparative Study of Aminolevulic Acid Photodynamic Therapy plus Pulsed Dye Laser versus Pulsed Dye Laser Alone in Treatment of Viral Warts

Smucler, Roman; Jatšová, E.

doi:10.1089/pho.2005.23.202

Cited by 47 publications

(40 citation statements)

References 10 publications

(10 reference statements)

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“…Ninety-six percent (73/76) of warts were cured in 2.54 sessions using photodynamic therapy with aminolevulinic acid-induced protoporphyrin as a photosensitizer, 293 and 100% (86/86) of warts were cured when the therapeutic modalities were combined. 294 Warts in a variety of locations were treated. These cure rates are very promising, but no information on recurrence was provided.…”

Section: Photoselective Dye Laser + Photosensitizer For Photodynamic mentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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Patients and clinicians experience the frustration of cutaneous viral warts caused by infection with the human papilloma virus (HPV).Warts appear in various forms on different sites of the body and include common warts (verruca vulgaris), plane or flat warts, myrmecia, plantar warts, coalesced mosaic warts, filiform warts, periungual warts, anogenital warts (venereal or condyloma acuminata), oral warts and respiratory papillomas. Cervical infection with HPV is now known to cause cervical cancer if untreated. A review of the medical literature reveals a huge armamentarium of wart monotherapies and combination therapies. Official evidence-based guidelines exist for the treatment of warts, but very few of the reported treatments have been tested by rigorous blinded, randomized controlled trials.Therefore, official recommendations do not often include treatments with reportedly high success rates, but they should not be ignored when considering treatment options. It is the purpose of this review to provide a comprehensive overview of the wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with problematic warts. Warts of the genital tract carry a much more ominous and pernicious threat for women in particular. It has been estimated that up to 70% of sexually active women become infected during their lifetime with human papillomavirus (HPV), the infective agent that causes warts. 3-5 A causal role for HPV infections in cervical cancer has been documented beyond reasonable doubt. HPV DNA is present in virtually all cervical cancer cases worldwide, with it being detected in 99.7% of an international series of cervical cancers by genetic amplification techniques and in 100% of cases as confirmed by histological review. 6,7 Cervical cancer is the most frequent common cancer in developing countries and the second most common cancer in women worldwide. 3 The association between HPV infection and cervical cancer is so strong that HPV is now considered the first positive cause of any human cancer ever identified. 3This raises the level of concerns over HPV prevention, screening and treatment from that of a nuisance condition to that of a major public health concern. Attention is beginning to focus on the viral factors that determine persistence and neoplastic progression to cancer and the possible role of HPV in other nongenital cancers (e.g., skin, upper aerodigestive tract). [8][9][10][11][12][13][14][15][16][17] Patients with warts seek advice from general practitioners, pharmacists, naturopaths, allied health professionals, family or friends, dermatologists, gynecologists, obstetricians and pediatricians for treatment and may present with recalcitrant warts that have been previously treated with anything from folk remedies to hypnosis to over-the-counter medications to more aggressive clinic-based treatments. Unfortunately, even with years of medical literature on this subject, high-quality, level I evidence for the efficacy of almost all treatments is no...

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Section: Photoselective Dye Laser + Photosensitizer For Photodynamic mentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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“…Until recently, the main application of PDT was to treat malignant and some benign lesions; 1,2 however, the efficacy of this procedure for microbial reduction has been demonstrated in several studies. [3][4][5][6] This emerging class of applications, which we refer to as antimicrobial photodynamic action (APDA), shows great potential. [7][8][9][10] Currently, lasers are the most common light sources used to activate the photosensitizers.…”

mentioning

confidence: 99%

Antimicrobial Photodynamic Action on Dentin Using a Light-Emitting Diode Light Source

Giusti

Pinto

Pizzolito

et al. 2008

Photomedicine and Laser Surgery

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Objective: The aim of this study was the evaluation of two different photosensitizers activated by red light emitted by light-emitting diodes (LEDs) in the decontamination of carious bovine dentin. Materials and Methods: Fifteen bovine incisors were used to obtain dentin samples which were immersed in brain-heart infusion culture medium supplemented with 1% glucose, 2% sucrose, and 1% young primary culture of Lactobacillus acidophilus 10 8 CFU/mL and Streptococcus mutans 10 8 CFU/mL for caries induction. Three different concentrations of the Photogem solution, a hematoporphyrin derivative (1, 2, and 3 mg/mL) and two different concentrations of toluidine blue O (TBO), a basic dye (0.025 and 0.1 mg/mL) were used. To activate the photosensitizers two different light exposure times were used: 60 sec and 120 sec, corresponding respectively to the doses of 24 J/cm 2 and 48 J/cm 2 . Results: After counting the numbers of CFU per milligram of carious dentin, we observed that the use of LED energy in association with Photogem or TBO was effective for bacterial reduction in carious dentin, and that the greatest effect on S. mutans and L. acidophilus was obtained with TBO at 0.1 mg/mL and a dose of 48 J/cm 2 . It was also observed that the overall toxicity of TBO was higher than that of Photogem, and that the phototoxicity of TBO was higher than that of Photogem. Conclusion: Based on our data we propose a mathematical model for the photodynamic effect when different photosensitizer concentrations and light doses are used.

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“…A study on the viral wart showed that PDT using an LED source achieved clearance rates of 81% (mean of 3.34 treatments). 4 Complete clearance of periungula hand warts in 18 of 20 patients (30 of 40 warts) was achieved in a pilot study of PDT with ALA after a mean of 4.5 treatments. 7 PDT leads to the release of inflammatory mediators, like interleukin 2, interleukin 1-b, and tumour necrosis factora, 9 suggesting that another mechanism for the clearance of these cells is in the indirect stimulation of local immune responses in the lesion area.…”

Section: Discussionmentioning

confidence: 99%

“…Topical photodynamic therapy (PDT) offers an effective and non-invasive treatment with good cosmetic outcome for intraepithelial neoplasia and inflammatory dermatosis, such as psoriasis and viral warts. [2][3][4] PDT with 10-20% Methyl aminolaevulinate (MAL) has been reported in successfully treating periungual warts and superficial squamous cell carcinoma (SCC), and has been approved in treating actinic keratosis (AK) and Bowen's disease (BD) that are intraepithelial SCC. [5][6][7] These disorders and PEH share similar histological features, namely epidermal hyperplasia.…”

mentioning

confidence: 99%

Pseudoepitheliomatous Hyperplasia Treated by Photodynamic Therapy with Variable Irradiation Dose and Concentration of Photosensitizer

Jiao²,

Long³

2011

Photomedicine and Laser Surgery

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Objective: The aim of this study was to test the effectiveness of photodynamic therapy (PDT) in treating pseudoepitheliomatous hyperplasia (PEH) after skin wounding. Background Data: PEH is a difficult-to-treat extreme-degree acanthosis characterized by proliferation of the epithelium. Topical PDT offers an effective and non-invasive treatment for intraepithelial neoplasia and inflammatory dermatosis. These disorders and PEH show the same histological features: epidermal hyperplasia. To our knowledge, there have been no clinical trials published about therapeutic responses of PDT for PEH. Materials and Methods: After application of 10-30% methyl aminolaevulinate (MAL) emulsion, each lesion was irradiated with 633-nm red light at a total dose of 113-339 J/ cm 2 . Therapeutic response was assessed by clinical examination at 3 months. Results: Only 4 of 16 lesions clinically showed a minimal response. No response was observed in 12 of the 16 lesions, either with different cumulative doses or different concentrations of MAL. Conclusion: PEH after skin wounding responds poorly to the topical MAL-PDT. Besides removal of underlying diseases, surgical excision is still the recommended first option.

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Comparative Study of Aminolevulic Acid Photodynamic Therapy plus Pulsed Dye Laser versus Pulsed Dye Laser Alone in Treatment of Viral Warts

Cited by 47 publications

References 10 publications

An Armamentarium of Wart Treatments

An Armamentarium of Wart Treatments

Antimicrobial Photodynamic Action on Dentin Using a Light-Emitting Diode Light Source

Pseudoepitheliomatous Hyperplasia Treated by Photodynamic Therapy with Variable Irradiation Dose and Concentration of Photosensitizer

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