Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research, College of Mathematics and Science, University of Central Oklahoma, Edmond, Oklahoma, USA.
J Biophotonics. 2019 Feb;12(2):e201800149. doi: 10.1002/jbio.201800149. Epub 2018 Oct 8.
Refractory cutaneous warts are difficult to eliminate. In situ photo-immunotherapy (ISPI) is an innovative treatment concept combining local photothermal therapy (PTT) and topical immunotherapy using imiquimod. To compare the efficacy of ISPI vs topical imiquimod alone, a prospective randomized controlled trial was performed with patients suffering from refractory cutaneous warts. In both groups, approximately 50% of the skin surface containing warts was treated for 6 weeks. On the basis of topical imiquimod, ISPI includes an additional 808 nm laser irradiation. Treatment response, temperatures during irradiation and histopathologic examination were evaluated. The complete response rate in the ISPI-group (22/36, 61.1%) was significantly higher than in the imiquimod alone group (11/34, 32.4%). In the ISPI-group, the mean maximum temperature was 44.5 ± 5.1°C, and obvious lymphocytic infiltration was found in the perivasculature of the dermis. There was no recurrence or worsening in both groups during the 12-month follow-up. No obvious adverse reaction was observed. This study demonstrates that ISPI can be used as an effective and safe treatment modality for refractory cutaneous warts.
难治性皮肤疣难以消除。原位光免疫疗法（ISPI）是一种将局部光热疗法（PTT）与咪喹莫特局部免疫疗法相结合的创新治疗概念。为了比较 ISPI 与单独使用咪喹莫特的疗效，对患有难治性皮肤疣的患者进行了一项前瞻性随机对照试验。在两组中，大约 50%的包含疣的皮肤表面接受了 6 周的治疗。在咪喹莫特的基础上，ISPI 还包括额外的 808nm 激光照射。评估了治疗反应、照射过程中的温度和组织病理学检查。ISPI 组（22/36，61.1%）的完全缓解率明显高于咪喹莫特单独组（11/34，32.4%）。在 ISPI 组中，平均最高温度为 44.5±5.1°C，真皮脉管周围有明显的淋巴细胞浸润。在 12 个月的随访中，两组均无复发或恶化。未观察到明显的不良反应。这项研究表明，ISPI 可作为治疗难治性皮肤疣的有效且安全的治疗方法。
