Lu Yuan-gang, Yang Ya-dong, Wu Jin-jin, Lei Xia, Cheng Qiong-hui, He Yang, Yang Wen
Plastic and Cosmetic Surgery Department, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
Photomed Laser Surg. 2012 Mar;30(3):186-90. doi: 10.1089/pho.2011.3040. Epub 2011 Nov 2.
The purpose of this study was to evaluate the treatment outcome and safety of topical photodynamic therapy (PDT) with aminolevulinic acid (5-ALA) combined with surgical curettage for perianal condyloma acuminata.
Condyloma acuminata is the most common sexually transmitted disease, with a high relapse rate, especially in the perianal area. The outcomes of many treatment methods for perianal genital warts are not satisfactory.
In this study, 40 cases of perianal condyloma acuminata were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) combined with curettage. First, the warts were removed with the patient under local anesthesia. The depth of the ablation and curettage reached the dermal layer. Then, the first session of PDT was performed after 2 days. Ten percent 5-ALA cream was applied to lesional skin with occlusive dressing for a 3-h incubation period and the lesions of warts were irradiated for 10 min by using a 635-nm laser beam of 177 mW/cm(2) intensity. The ALA-PDT was repeated after 1 and 3 weeks. Follow-up evaluation was performed at our outpatient clinic at 1 and 3 months after completion of therapy. Before treatment and at each follow-up visit, the lesions were photographed; the treatment outcome was evaluated as recurrence rate, and patient satisfaction was surveyed.
After three PDT sessions following surgical curettage, all 40 patients were cured and there was no recurrence at 1 month off treatment. At 3 months off treatment, six cases relapsed, corresponding to a recurrent rate of 15%. The satisfaction rate of patients was 100% at 1 month and 95% at 3 months after treatment.
Combination of surgical curettage and topical PDT has been proven to be a safe and effective procedure, and may offer a wide clinical application for the treatment of perianal condyloma acuminata.
本研究旨在评估外用氨基酮戊酸（5-ALA）光动力疗法（PDT）联合手术刮除术治疗肛周尖锐湿疣的疗效及安全性。
尖锐湿疣是最常见的性传播疾病，复发率高，尤其是在肛周区域。许多治疗肛周生殖器疣的方法效果并不理想。
本研究中，40例肛周尖锐湿疣患者接受了外用氨基酮戊酸光动力疗法（ALA-PDT）联合刮除术治疗。首先，在局部麻醉下为患者去除疣体。刮除深度达真皮层。然后，2天后进行首次PDT治疗。将10%的5-ALA乳膏涂抹于皮损处，用封闭敷料覆盖3小时，然后使用强度为177 mW/cm²的635 nm激光束对疣体照射10分钟。1周和3周后重复ALA-PDT治疗。治疗完成后1个月和3个月在门诊进行随访评估。治疗前及每次随访时，对皮损进行拍照；评估治疗效果为复发率，并对患者满意度进行调查。
手术刮除术后进行三次PDT治疗后，40例患者均治愈，停止治疗1个月时无复发。停止治疗3个月时，6例复发，复发率为15%。治疗后1个月患者满意度为100%，3个月时为95%。
手术刮除术与外用PDT联合已被证明是一种安全有效的方法，可能为肛周尖锐湿疣的治疗提供广泛的临床应用。
