Treatment of anogenital condylomata acuminata with topical photodynamic therapy: report of 14 cases and review

Summary Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is an emerging technique for the treatment of genital human papillomavirus (HPV)-induced benign and premalignant lesions. We report herein a case series of anogenital CA successfully treated with ALA-PDT and review the literature available to date on this topic. Thirteen out of 14 cases of anogenital condylomata acuminata were successfully treated with topical PDT. We conclude that PDT can be considered a highly effective and safe treatment option for anogenital condylomata acuminata. Also, considering the available literature, the best results are likely to be achieved with a 16–20% gel formulation of 5-ALA and a red light dose of 100–150J/cm 2

Photodynamic therapy for chronic venous ulcers

Some laboratory findings and a few case reports support the treatment of chronic venous ulcers with photodynamic therapy. We treated 19 patients with refractory chronic venous ulcers using photodynamic therapy. The ulcers healed in 15 cases (78.9%) after an average of 6.8 photodynamic therapy sessions (range 6.0-8.0). In the remaining 4 cases, the ulcers showed marked improvement after 10 photodynamic therapy sessions. Photodynamic therapy seems to represent a good alternative therapeutic choice for refractory chronic venous ulcers.</p

Cellular response to photodynamic therapy in chronic wounds

A wound is considered chronic if it does not heal timely. Basic processes at work are similar to acute healing, but their persistence leads to abundant granulation tissue and possibly fibrosis, scar contraction and loss of function [1]. Wounds may become chronic because of local and systemic conditions and are a major concern in clinical dermatology. Photodinamic therapy (PDT) has been proposed for these cases, through the administration of aminolaevulinic acid (ALA), leading to the synthesis of the photosensitizer protoporphyrin IX (PpIX), followed by illumination with visible light [2]. To study the effects of this therapy on the cell infiltrate of chronic wounds, cryosections of lesions before and after PDT were post fixed in cold acetone and stained with haematoxilin and eosin or immunolabeled with antibodies to laminin 5 (for basement membrane), HSP47 (for fibroblasts), alpha-smooth muscle actin (for myofibroblasts), SPM250 (for granulocytes). Intact neighbor skin was used as control. The cellular infiltrate, as well as the thickness of epidermis, the vascularization and the number of fibroblasts appeared increased in chronic wounds over healthy skin. After completion of PDT, fibroblasts appeared further increased in number, the treatment seemed to stimulate the connective tissue cells responsible for tissue repair rather than the inflammatory infiltrate (Supported by Ente Cassa di Risparmio di Firenze, grant 3681 to S.B.)