Phototherapy in Atopic Dermatitis

Atopic dermatitis (AD) is an inflammatory, recurrent and chronic disease that occurs in 2–10% of the population. Therapy of AD could be divided into topical (corticosteroids, calcineurin inhibitors) and systemic (cyclosporine, methotrexate, azathioprine or biological treatment). Phototherapy is taken into consideration as a second-line treatment, when topical therapy is unsuccessful. We distinguish many types of phototherapy, e.g. narrowband UVB (311–313 nm), UVA-1 therapy (340–400 nm), UVA/B combination, UVA therapy plus 8-methoxypsoralens (PUVA), 308 nm excimer laser (EL) and blue light. Phototherapy is effective in many cases, whether in adults or in children. It should be remembered that during therapy possible side effects may occur. Among them the risk of carcinogenesis is the most severe

Correlation of the ALA-PDT Treatment Efficacy and the HPV Genotype Profile of Genital Warts after Cryotherapy Failure and Podophyllotoxin Therapy in Male Patients

Background: Genital warts are the manifestation of the human papillomavirus (HPV) infection, which may last for weeks or months before the clinical presentation. The primary aim of the study was the correlation of the DNA HPV genotypes eradication with the treatment response in male patients with persistent genital warts. Methods: Twenty-one male patients (age range: 22–58) after failure of cryotherapy and podophyllotoxin treatment were enrolled in the study. Genetic tests (Real Time - PCR method) analyzed the presence of DNA-HPV before and 6 months after four sessions (4 weeks apart) of photodynamic therapy with 5-aminolaevulinic acid (ALA-PDT). The treatment efficacy was evaluated before each PDT session and at the end of the study. Results: The single HPV DNA type was present in 15/21 of the patients (13/15 HPV6). The high-risk HPV types were found in 8/21 subjects, of which 6/8 had several types. Six months after four sessions of PDT, complete response was found in 16/21 (76.19%; p = 0.0007) of patients, and DNA HPV clearance was found in 66.67% (p = 0.03). The eradication rate differed among patients with primary low-risk and high-risk HPV types—76.92% (10/13; p = 0.0003) and 50% (4/8; p = 0.05) respectively. Conclusion: ALA-PDT is an effective treatment even after the failure of previous modalities. The persistence of clinical lesions and high oncological risk HPV types should be an indication for treatment prolongation