Treatment of condyloma acuminatum using the combination of laser ablation and ALA-PDT

Photodiagnosis Photodyn Ther. 2019 Mar:25:193-196. doi: 10.1016/j.pdpdt.2018.12.006. Epub 2018 Dec 20.

Abstract

Background: Human papilloma virus (HPV) infection and condyloma acuminatum (CA) in the genital area often exist in extensive and multi-point fashion. Laser ablation combined with topical photodynamic therapy (PDT) is a feasible approach for genital CA but its effectiveness and limitations need to be evaluated.

Methods: This single-arm prospective study consisted of 100 newly diagnosed CA cases of both sexes. All patients underwent laser ablation and then three times aminolaevulinic acid-based photodynamic therapy (ALA-PDT). The outcomes were evaluated and analyzed 3 months after the treatment.

Results: A total of 98 patients completed the study. Except for 6 patients (4 males and 2 females) showed some residual lesions other 92 patients (93.8%) showed complete cure. However, there were 18 patients (10 males and 8 females) showed new lesions near the treated areas. Although the HPV types of 18 patients before and after treatment were not completely consistent, 94.4% percent of patients (17/18) had the same HPV type as the primary lesion, which suggested that these late-onset CA might have latent infection or subclinical infection in the early stage of the disease but the length of the incubation period was longer.

Conclusion: Combination approach is effective in treating genital CA and preventing CA recurrence. But its limitations need to be recognized as the late-onset CA might occur near the treated area. The treatment plan needs to be optimized for multiple genital CA lesions.

Keywords: Genital warts; Laser; Photodynamic therapy, HPV.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aminolevulinic Acid / therapeutic use*
  • Combined Modality Therapy
  • Condylomata Acuminata / drug therapy
  • Condylomata Acuminata / radiotherapy
  • Condylomata Acuminata / therapy*
  • Female
  • Humans
  • Laser Therapy / methods*
  • Lasers, Gas / therapeutic use
  • Male
  • Middle Aged
  • Papillomavirus Infections / drug therapy
  • Papillomavirus Infections / radiotherapy
  • Papillomavirus Infections / therapy*
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use*
  • Prospective Studies
  • Young Adult

Substances

  • Photosensitizing Agents
  • Aminolevulinic Acid