Chong Wei-Sheng, Kang Gregory Yirun Michael
National Skin Center, 1 Mandalay Road, Singapore 308205, Singapore.
Photodermatol Photoimmunol Photomed. 2009 Aug;25(4):225-6. doi: 10.1111/j.1600-0781.2009.00439.x.
A 20-year-old man presented with a 3-month history of a viral wart located on his right thumb. Cryotherapy was administered weekly to the wart over 5 months without any significant improvement. A decision was made to treat the wart with red light photodynamic therapy (PDT) using topical methyl aminolevulinate (MAL) administered as three treatments 1-week apart. The patient was reviewed 4 weeks after the third treatment and the wart was found to have cleared completely. Three months after the last treatment, there remained no clinical evidence of recurrence of the wart. Pain was the main problem with the treatment but it was tolerable. Although the successful treatment of recalcitrant acral viral warts with PDT using 5-aminolevulinic acid (ALA) is well documented, this is the first report of the successful PDT treatment of a recalcitrant acral viral wart using the methylester derivative of ALA. We believe that MAL is a valuable alternative photosensitizer to ALA as it is more lipophilic, has better penetration and causes less pain.
一名20岁男性患者，右手拇指出现病毒疣3个月。在5个月内每周对疣体进行冷冻治疗，但无明显改善。决定采用外用甲基氨基酮戊酸（MAL）进行红光光动力疗法（PDT）治疗该疣体，分三次治疗，每次间隔1周。第三次治疗后4周对患者进行复查，发现疣体已完全清除。最后一次治疗3个月后，临床上未发现疣体复发迹象。疼痛是治疗的主要问题，但可以耐受。尽管使用5-氨基酮戊酸（ALA）进行PDT成功治疗顽固性手足部病毒疣已有充分文献记载，但这是首次使用ALA甲酯衍生物成功进行PDT治疗顽固性手足部病毒疣的报告。我们认为MAL是ALA一种有价值的替代光敏剂，因为它具有更强的亲脂性、更好的穿透力且引起的疼痛更少。
