The Efficacy of Photodynamic Therapy with Methyl 5-aminolaevulinate for the Treatment of Viral Wart

Baek, Jae Woo; Suh, Kee Suck; Kim, Sang Tae; Jeon, Young Seung

Abstract

BACKGROUND
Photodynamic therapy (PDT) with methyl 5-aminolaevulinate (MAL) has proven to be useful for the treatment of a wide variety of benign and malignant dermatologic conditions. More recently, this therapeutic modality has emerged as an alternative therapy for viral wart.
OBJECTIVE
The purpose of this study was to evaluate the efficacy and safety of PDT for treating viral warts with using a light-emitting diode (LED) device and MAL.
METHODS
Fifteen patients with a total of 34 warts were treated with MAL under an occlusive dressing for 3 hours and this was followed by irradiation with a LED device at a wavelength of 633+/-3 nm and a fluence of 37 J/cm2. The treatment was repeated at 1~2 weeks until all the lesions cleared. The side effects, including pain, hyperpigmentation and pruritus, were recorded on a progress chart. The intensity of pain was assessed by using a 5-point verbal rating scale (VRS).
RESULTS
A total of 34 warts from 15 patients (9 males and 6 females) were treated with MAL-PDT. The sites of the lesion were classified as periungal (26%), sole (18%) and others (56%). After an average of 2.15+/-0.61 therapeutic sessions (MAL+PDT) for 34 warts, the number of complete, partial and no responses were 27/34 (79.4%), 7/34 (20.6%) and 0/34 (0%), respectively. The overall complete response rates were 66.7% for the periungal warts, 50% for the sole warts and 94.7% for the others. The pain after the first treatment was more intense and deeper as compared with that after the second treatment. There were no recurrences of the warts that had a complete response during the follow-up period (from 6 to 12 months).
CONCLUSION
We suggest that MAL-PDT is an effective and safe alternative therapy for viral warts.