Chen Jiaoquan, Xie Xinyi, Liu Yingxue, Chen Fengyi, Gong Yeqing, Liang Bihua, Wu Yiling, He Shiqi, Li Yueming, Zhu Huilan, Ma Shaoyin
Department of Dermatology, Guangzhou Dermatology Hospital (Guangzhou Institute of Dermatology), Guangzhou, Guangdong 510095, China.
Department of Dermatology, Guangzhou Dermatology Hospital (Guangzhou Institute of Dermatology), Guangzhou, Guangdong 510095, China.
Photodiagnosis Photodyn Ther. 2025 Feb;51:104407. doi: 10.1016/j.pdpdt.2024.104407. Epub 2024 Nov 16.
Plantar warts, benign lesions on the soles of the feet, are caused by the human papillomavirus (HPV) infecting keratinocytes. Complete eradication of these warts is challenging, often leading to recurrences. This study evaluates the combined clinical efficacy of topical 5-aminolevulinic acid (5-ALA) photodynamic therapy (PDT) and fractional carbon dioxide (CO) laser treatment for recalcitrant plantar warts.
Data from 10 patients with recalcitrant plantar warts were analyzed. Initially, thickened hyperkeratotic tissue was removed using a super-pulsed CO laser. This was followed by fractional laser application, after which a 20 % 5-ALA cream was applied occlusively for 4 h. Patients then received He-Ne laser irradiation for 30 min at an energy density of 100 mW/cm², with treatments spaced 4 weeks apart.
The study included 10 participants aged 24 to 53 years (mean age: 33.4 ± 8.09 years). In total, 40 lesions were treated across 1 to 9 PDT sessions, with an average of 5.2 ± 2.86 sessions per patient. Complete clearance was achieved in 3 patients (30 %), 4 patients (40 %) showed an excellent response (≥80 % improvement), while 2 patients had a partial response. One patient (10 %) showed <50 % improvement. The overall clearance rate was 70 % (28 out of 40 lesions). Aside from temporary pain during the procedure and mild erythema post-treatment, one patient developed localized proliferative scarring. After a one-year follow-up, only one patient experienced recurrence.
The combination of 5-ALA PDT and fractional CO laser therapy shows promise as an effective and safe alternative for treating persistent plantar warts.
跖疣是足底的良性病变，由人乳头瘤病毒（HPV）感染角质形成细胞引起。彻底根除这些疣体具有挑战性，常导致复发。本研究评估外用5-氨基酮戊酸（5-ALA）光动力疗法（PDT）联合分次二氧化碳（CO）激光治疗顽固性跖疣的综合临床疗效。
分析10例顽固性跖疣患者的数据。首先，使用超脉冲CO激光去除增厚的角化过度组织。随后进行分次激光治疗，之后外用20%的5-ALA乳膏封闭4小时。然后患者接受能量密度为100 mW/cm²的氦氖激光照射30分钟，治疗间隔为4周。
该研究纳入了10名年龄在24至53岁之间的参与者（平均年龄：33.4±8.09岁）。总共对40个疣体进行了1至9次PDT治疗，每位患者平均接受5.2±2.86次治疗。3例患者（30%）实现了完全清除，4例患者（40%）显示出极佳的反应（改善≥80%），而2例患者有部分反应。1例患者（10%）改善不足50%。总体清除率为70%（40个疣体中的28个）。除了治疗过程中的短暂疼痛和治疗后的轻度红斑外，1例患者出现了局部增生性瘢痕。经过一年的随访，只有1例患者复发。
5-ALA PDT联合分次CO激光治疗显示出有望成为治疗持续性跖疣的一种有效且安全的替代方法。
