Photodynamic therapy using light‐emitting diodes for the treatment of viral warts

Abstract

Photodynamic therapy with topical 5-aminolevulinic acid is an effective and safe treatment for actinic keratosis and superficial non-melanoma skin cancer. Further, some studies have reported good efficacy when using photodynamic therapy to treat viral warts. The light-emitting diode is an incoherent, narrow-spectrum light source. The purpose of this study is to evaluate the efficacy of photodynamic therapy using a light-emitting diode for viral warts. Six patients with a total of 41 foot and hand warts were recruited in this study. They were treated with 20% 5-aminolevulinic acid cream under occlusion for 5 h. Thereafter, the treated area was irradiated with the light from a red light-emitting diode (633 +/- 6 nm) with a dose of 126 J/cm(2). This treatment was repeated at 2- or 3-week intervals. The rate of improvement observed in patients was 68.3%. The adverse effects included mild to moderate pain and erythema, which was well-tolerated by all six patients. No patients withdrew from the study due to the adverse effects. Photodynamic therapy with topical 5-aminolevulinic acid using the light from a red light-emitting diode has the advantage of non-invasiveness, minimal associated adverse reactions, and production of good results in a significant proportion of cases: therefore, it is an alternative treatment for recalcitrant viral warts.

Efficiency of Photodynamic Therapy in the Treatment of Diffuse Facial Viral Warts in an Immunosuppressed Patient: Towards a Gold Standard

“…Several studies have shown that PDT is efficient in treating plane warts [14, 15], including those on the face [16]. Ohtsuki et al [17] treated verrucae vulgares on the hands and feet with a clear clinical improvement in 68.3% of the patients. This improvement was confirmed by a placebo-controlled study led by Bastuji-Garin et al [18].…”

“…It is a safe, noninvasive technique, which yields effective therapeutic results in multiple series of patients [17, 23]. The risk of secondary infection after PDT is insignificant, and the cosmetic results are excellent [7].…”

Viral infections of the hand

“…Photodynamic therapy using infraredspectrum light resulted in 60% cure rate of periungual warts and 75% cure rate of other hand warts. 19,20 Laser treatment has resulted in cure rates in excess of 90% in other studies. 21,22 Surgery should be reserved for cases in which all other treatments have been exhausted and the patient still desires treatment, or when excisional biopsy is indicated because of confusion with malignancy or premalignancy.…”

Trends and targets in antiviral phototherapy

“…Among these, due to the localized PDT treatment, the most common application is the treatment of different manifestations of HPV, 24a,224,231,232,233,234 e.g., acral 233,235,236,237,238,239,240,241,242 and facial 243,244,245 warts or warts in the genital region (Condylomata acuminata). 219,246,247,248,249,250,251,252,253,254,255,256,257 In addition, antiviral PDT has been of interest in the treatment of recurrent respiratory papillomatosis.…”

“…246 For the most part, ALA has been employed, however methyl aminolevulinate (MAL) and hexaaminolevulinate (HAL) have been applied successfully as well. 235,237 In the majority of these studies the efficiency of PDT for the treatment of viral warts has been demonstrated, 233,235,236,237,238 though there are also studies in which only a moderate efficiency of PDT was observed. 239 In a study by Fuchs et al light alone (water-filtered infrared A) achieved a considerable effect.…”