Comparative study of photodynamic therapy with 5%, 10% and 20% aminolevulinic acid in the treatment of generalized recalcitrant facial verruca plana: a randomized clinical trial. (25th November 2013)

• Record Type: Journal Article
• Authors: Li, Q.; Jiao, B.; Zhou, F.; Tan, Q.; Ma, Y.; Luo, L.; Zhai, J.; Luan, Q.; Li, C.; Wang, G.; Gao, T.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 28:Number 12(2014:Dec.)
• Page Start: 1821
• Page End: 1826
• Publication Date: 2013-11-25
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12319
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" id="jdv12319-abs-0001"> <title>Abstract</title> <sec id="jdv12319-sec-0001" sec-type="section"> <title>Background</title> <p>Generalised recalcitrant facial verruca plana responds poorly to current therapeutic options, including cryotherapy, topical drugs and carbon dioxide (CO<sub>2</sub>) laser. Case reports and uncontrolled studies suggested that topical photodynamic therapy (PDT) is effective choice of treatment free from potential complications associated with invasive therapies.</p> </sec> <sec id="jdv12319-sec-0002" sec-type="section"> <title>Aims</title> <p>To investigate the efficacy and safety of PDT with different concentrations of photosensitiser in the treatment of verruca plana.</p> </sec> <sec id="jdv12319-sec-0003" sec-type="section"> <title>Materials & Methods</title> <p>The two sides of a subject's face were separately randomized to receive aminolevulinic acid (ALA) of 5%, 10% or 20% concentration. All patients were irradiated with 633‐nm red light for 339 J/cm<sup>2</sup> total dose. Complete response (CR) rate was assessed on Week 4, 8, and 16 respectively.</p> </sec> <sec id="jdv12319-sec-0004" sec-type="section"> <title>Results</title> <p>The mean overall clearance rate was 74.1%, 68.8%, and 64.6% on Week 4, 8, and 12, respectively, in the 110 treated sides. The CR rate was lower in the 5%‐ALA group than in the 10%‐ALA group (14.3% <italic>vs</italic>. 33.3%, <italic>p</italic> < 0.05) and 20%‐ALA group (14.3% <italic>vs</italic>. 26.3%, <italic>p</italic> < 0.05) after 12 weeks. The mean severity of pain measured by visual analogue scale (VAS) scoring was 3.8 (range: 2 to 10, depending on the lesion location). The overall recurrence rate was 16.7% (4/24) on Week 12. Hyperpigmentation was observed in 61% (67/110) of all treated sides. On Week 4, 8, and 16, hyperpigmentation was more developed in the 20%‐ALA group than in the other two groups (<italic>p</italic> < 0.05).</p> </sec> <sec id="jdv12319-sec-0005" sec-type="section"> <title>Discussion</title> <p>In terms of complete clearance rate, the 5% ALA‐PDT group was significantly inferior to the 10% and 20% ALA‐PDT groups at each follow‐up. In contrast, the 20% ALA group showed a higher incidence rate of transient hyperpigmentation than the other two groups.</p> </sec> <sec id="jdv12319-sec-0006" sec-type="section"> <title>Conclusions</title> <p>This randomised clinical trial suggests that PDT with ALA of 10% concentration offers better efficacy and safety than 5% or 20% concentration for generalised recalcitrant facial verruca plana.</p> </sec> </abstract>