Treatment of lip florid papillomatosis with topical ALA-PDT combined with curettage: Outcome and safety

Abstract Background Photodynamic therapy (PDT) is a successful treatment in clinical practice. PDT is increasingly used to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the treatment outcome and safety of PDT with aminolevulinic acid (5-ALA) combined with surgical curettage for lip florid papillomatosis. Methods In this study, 4 cases of lip florid papillomatosis were treated with topical aminolevulinic acid photodynamic therapy (ALA-PDT) combined with curettage. First, the warts were removed with the patient under local anesthesia. The depth of the ablation and curettage reached the dermal layer. Then, the first session of PDT was performed after 2 days. Ten percent 5-ALA cream was applied to lesional skin with occlusive dressing for a 3-h incubation period and the lesions of warts were irradiated for 10 min by using a 635-nm laser beam of 177 mW/cm2 intensity. The ALA-PDT was repeated after 1 and 3 weeks and two other treatments applied if necessary. Follow-up evaluation was performed at our outpatient clinic at 3 and 6 months after completion of therapy. Results After three PDT sessions following surgical curettage, 3 patients were cured at 3 months off treatment, one cases relapsed, corresponding to a recurrent rate of 25%. There was no other recurrence at 6 months off treatment. The satisfaction rate of patients was 95% at 3 month and 100% at 6 months after treatment. Conclusions The combined treatment of topical ALA-PDT and curettage was proven to be safe and effective in lip florid papillomatosis