Wu Yun, Sun Xiaofei, Yan Yu, Zhou Zhongxia, Chang Qihang, Chen Diyan, Yan Jia, Zhang Haiyan, Wang Xiuli
Shanghai Skin Disease Hospital, School of Medicine, Institute of Photomedicine, Tongji University, 1278 Baode Road, Shanghai 200443, China.
Shanghai Skin Disease Hospital, School of Medicine, Institute of Photomedicine, Tongji University, 1278 Baode Road, Shanghai 200443, China.
Photodiagnosis Photodyn Ther. 2024 Apr;46:104022. doi: 10.1016/j.pdpdt.2024.104022. Epub 2024 Feb 22.
Photodynamic therapy (PDT) is proved effective for treating low-grade squamous intraepithelial lesions (LSIL) and condylomata acuminata (CA). 5-Aminolevulinicacid (5-ALA) is the most common applied photosensitizer, but high rate of unbearable pain and relative long incubation time were reported. Here, we report a 27-year-old woman suffering from cervical and vaginal giant CA with LSIL involving the whole right vaginal fornix, cervical surface, and vaginal wall. Holmium yttrium aluminum garnet (Ho: YAG) laser was first applied to remove the giant CA lesions. STBF, a derivative of chlorin e6 (Ce6) was then applied on suspicious lesions as a new photosensitizer for 1 h. Lesions were exposed to LED illumination with a wavelength of 630 nm and light dose of 200-284 J/cm for cervical canal and the vaginal surfaces, 100-150 J/cm for cervix surface. Vaginal giant CA and LSIL lesions got complete remission at 6-month follow-up. Mild tolerable adverse reactions were observed after STBF-PDT and relieved in 24 h. Thus, the combination of Ho: YAG laser and STBF-PDT may be a novel option for cervical and vaginal giant CA and LSIL, especially for special vaginal fornix areas.
光动力疗法(PDT)已被证明对治疗低度鳞状上皮内病变(LSIL)和尖锐湿疣(CA)有效。5-氨基乙酰丙酸(5-ALA)是最常用的光敏剂,但有报道称其疼痛难以忍受的发生率较高且孵育时间相对较长。在此,我们报告一名27岁女性,患有宫颈和阴道巨大尖锐湿疣,伴有LSIL累及整个右侧阴道穹窿、宫颈表面和阴道壁。首先应用钬钇铝石榴石(Ho:YAG)激光去除巨大尖锐湿疣病变。然后将二氢卟吩e6(Ce6)的衍生物STBF作为一种新的光敏剂应用于可疑病变1小时。宫颈管和阴道表面的病变接受波长为630nm、光剂量为200 - 284J/cm²的LED光照,宫颈表面为100 - 150J/cm²。在6个月的随访中,阴道巨大尖锐湿疣和LSIL病变完全缓解。STBF - PDT后观察到轻度可耐受的不良反应,并在24小时内缓解。因此,Ho:YAG激光和STBF - PDT联合应用可能是治疗宫颈和阴道巨大尖锐湿疣及LSIL的一种新选择,特别是对于特殊的阴道穹窿区域。