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Photodiagnosis and treatment of condyloma acuminatum using 5-aminolevulinic acid and homemade devices

机译:5-氨基乙酰丙酸和自制装置对尖锐湿疣的光诊断和治疗

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Background: The objective of this study was to improve the feasibility of applying topic 5-aminolevulinic acid (ALA) in photodiagnosis (PD) and treatment of condyloma caused by human papillomavirus (HPV) using two homemade handheld devices and to discuss the photody-namic therapy (PDT) as a suitable alternative for each of the cases studied. Both, protoporphyrin IX production and photodegradation were analyzed, and the pain experienced during the illumination was correlated with the light intensities. Methods: A total of 40 women with different grades of lesions caused by HPV were chosen from patients of the School of Medicine of Ribeirao Preto (University of Sao Paulo) and of the Unit of Public Health of Araraquara, Sao Paulo. Results: We did not encounter any unexpected difficulties using our devices during the treatment. The existence of an easily observable reddish fluorescence with large intensity concentrated on the lesions is the clinical indication of the penetration and the selective concentration of protoporphyrin IX in the clinical and subclinical lesions rather than in the healthy tissue. The aesthetic results were much better than those obtained by conventional techniques as surgery or cryogenics, with no recurrence reported after two years of treatment. Conclusions: Our results are proof for the various advantages using ALA cream for the PD and PDT in many different cases of condyloma by HPV. This study will be continued to investigate the PplX photobleaching and the irradiance and fluence rate to optimize conducting the clinical trials, to improve the devices and therefore increase the treatment response.
机译:背景:这项研究的目的是使用两个自制的手持设备提高主题5-氨基乙酰丙酸(ALA)在光诊断(PD)和治疗人乳头瘤病毒(HPV)引起的尖锐湿疣中应用的可行性,并讨论光动力治疗(PDT)作为每种研究案例的合适替代方法。分析了原卟啉IX的产生和光降解,并且照明期间经历的疼痛与光强度相关。方法:从圣保罗大学里贝拉奥·普雷图医学院和圣保罗阿拉拉夸拉公共卫生部门的患者中选出40名不同程度由HPV引起的病变的女性。结果:在治疗过程中,使用我们的设备没有遇到任何意外的困难。在病灶上存在易于观察到的大强度红色荧光,是临床和亚临床病灶而非健康组织中原卟啉IX的渗透和选择性浓度的临床指标。美学结果比通过常规技术获得的手术或低温技术要好得多,治疗两年后未见复发。结论:我们的结果证明了在许多不同的HPV尖锐湿疣病例中,使用ALA乳膏治疗PD和PDT有多种优势。这项研究将继续进行,以研究PplX的光致漂白以及辐照度和注量速率,以优化进行临床试验,改善设备并因此增加治疗反应的能力。

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