二氧化碳激光打孔预处理联合5-氨基酮戊酸光动力治疗难治性巨大跖疣

Treatment of Recalcitrant Plantar Warts with 5-aminolevulinic Acid Photodynamic Therapy(ALA-PDT)after Preconditioning with Superpulse Carbon Dioxide Laser

【目的】探讨二氧化碳激光打孔预处理联合5-氨基酮戊酸(ALA)光动力治疗难治性巨大跖疣的疗效和安全性。【方法】入组难治性巨大跖疣患者,采用二氧化碳激光打孔预处理疣体组织,再进行ALA光动力治疗,评估治愈率和不良反应。【结果】20例患者接受1-3次光动力治疗后,治愈率达85%(17/20)。其中2例(10%)接受1次治疗,5例(25%)接受2次治疗,10例(50%)接受3次治疗。均未见感染或瘢痕。人乳头瘤病毒(HPV)单一型别感染5例,双重或多重HPV型别感染15例,两组之间跖疣治愈率无统计差异。【结论】采用超脉冲二氧化碳激光打孔联合光动力治疗,可提高巨大难治性跖疣的治疗效果。HPV型别与难治性跖疣病情和治疗预后的相关性有待进一步深入研究。

【Objective】To investigate the efficacy and safety of ALA-PDT following CO_2 laser preconditioning for recalcitrant plantar warts.【Methods】Patients with recalcitrant plantar warts were enrolled in this study,and received ALA-PDT treatment following CO_2 laser preconditioning. Cure rate and side effects were observed.【Results】Twenty patients were enrolled and 85%(17/20)showed complete clearance of plantar warts after one to three times of ALA-PDT. PDT treatment time was once in two patients(10%),twice in five patients(25%)while three times in 10 patients(50%). No infection or scar tissue was observed. Five(25%)patients were infected with one type of HPV,while 15(75%)patients with two or multiple types of HPV. No difference was observed in complete clearance rate between patients with single or multiple HPV genotypes infection.【Conclusions】Superpulse carbon dioxide laser pretreatment enhanced the efficacy of ALA-PDT treatment on recalcitrant plantar warts. Further study is needed to determine the association of HPV genotype with outcome of recalcitrant plantar warts.