5-氨基酮戊酸光动力疗法治疗甲周疣一例

临床资料 患儿,女,10岁。主因左足拇趾甲板疣状斑块、甲床破坏1年,于2012年2月4日就诊。患儿1年前因左足拇趾外伤患甲周炎伴甲下积脓,当地医院予抗感染治疗（具体不详）后炎症消退,数周后患儿家长发现患儿左足拇趾甲游离缘浑浊、增厚,邻近皮肤有数个疣状损害,患儿无自觉症状。后因甲缘病灶扩大、甲板毁损,在当地医院就诊,诊断甲缘疣,予冷冻治疗,治疗后病灶仅部分消退。     

光动力治疗甲周疣10例临床疗效观察

目的探讨5-氨基酮戊酸光动力疗法治疗甲周疣的疗效与安全性。方法对入选的10例甲周疣患者经5-氨基酮戊酸光动力疗法治疗,随访3个月后进行临床疗效评价。结果入选患者经3~5次光动力治疗,平均3.5次,所有皮损均得到清除,且无明显不良反应。3个月后随访,仅1个皮损复发。结论 5-氨基酮戊酸光动力疗法治疗甲周疣疗效好,安全可靠。     

胸腺肽联合液氮冷冻治疗儿童甲周疣疗效观察

目的观察胸腺肽联合液氮冷冻治疗儿童甲周疣的临床疗效。方法120例儿童甲周疣患者随机分为治疗组(60例)及对照组(60例),治疗组予胸腺肽肌肉注射,2天1次,共15次,疣体采用液氮冷冻治疗1-3次。对照组仅行液氮冷冻治疗。结果治疗组有效率为91.1%,对照组为62.0%,治疗组疗效优于对照组,两组有效率差异有显著性(P<0.01)。结论胸腺肽联合液氮冷冻治疗儿童甲周疣疗效确切。     

局部5-氨基酮戊酸光动力疗法治疗甲周疣的疗效观察

目的观察局部5-氨基酮戊酸(5-aminolevulinic acid,5-ALA)光动力疗法治疗甲周疣的疗效和安全性。方法甲周疣16例患者。将用20%的5-ALA溶液浸润的薄棉花片覆盖手足皮损处,避光4-5 h。移除湿敷棉花片,用波长为635 nm的激光照射病灶部位,能量密度120 J/cm2,照射时间20～25 min。治疗3次,每隔14 d治疗1次。疗程结束后2周、4周复诊,评价治疗效果。结果治疗2周后,12例患者完全治愈,4例有效;4周后,14例治愈,2例有效。患者有效率、满意率为100%。结论局部5-ALA光动力疗法治疗甲周疣疗效显著、安全,不良反应小。     

二氧化碳点阵激光联合5-氨基酮戊酸光动力疗法治疗顽固性甲周疣的临床观察

目的:观察二氧化碳点阵激光联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗顽固性甲周疣的疗效及安全性。方法:将31例顽固性甲周疣患者(76个皮损)随机分为观察组和对照组,观察组16例(40个皮损)予CO2点阵激光联合ALA-PDT治疗,对照组15例(36个皮损)予ALA-PDT治疗,两组均治疗3次,每隔14天1次,第3次治疗结束2周后评价疗效和不良反应,3个月后随访观察复发率,并进行比较。结果:观察组治愈率为100%(40/40),未见复发;对照组治愈率为72.22%(26/36),复发率为15.38%(4/26)。两组治愈率和复发率差异均有统计学意义(P值均<0.01)。两组不良反应均轻微。结论:CO2点阵激光联合ALA-PDT治疗顽固性甲周疣具有良好的疗效和安全性。     

聚肌胞联合液氮冷冻治疗甲周疣33例疗效观察

目的探讨聚肌胞联合液氮冷冻治疗甲周疣的疗效。方法治疗组33例，采用聚肌胞联合液氮冷冻治疗；对照组32例，单用液氮冷冻治疗。结果治疗组有效率为93．94％，对照组为71．88％，两组比较差异有统计学意义（P〈0．05）；治疗组伤口愈合、皮损脱落时间比对照组明显缩短（P〈0．05）。结论用聚肌胞联合液氮冷冻治疗甲周疣起效快，疗程短，疗效显著。     

雀啄灸联合冷冻治疗儿童甲周疣的临床疗效观察

目的 探讨雀啄灸联合冷冻治疗儿童甲周疣的临床疗效.方法 选取2019年2月—2020年3月于首都儿科研究所附属儿童医院就诊的126例甲周疣患儿,按照随机对照方法分为治疗组(63例)与对照组(63例),治疗组采用雀啄灸联合冷冻治疗,对照组采用冷冻治疗.比较2组的有效率、不良反应发生率和复发率.结果 治疗组的总有效率为95...     

光动力疗法在皮肤疣治疗中的应用进展

皮肤疣是由人乳头瘤病毒感染所引起的良性传染性上皮肿瘤，治疗的目的是治愈患者的身体和心理不适，防止自身接种感染和传染给他人。对于疣的治疗，目前尚没有非常可信赖的方法，传统的侵袭性治疗常给患者带来痛苦，局部光动力疗法具有操作简单、不良反应少和美容效果好的优点。本文拟综述局部光动力疗法在皮肤疣治疗中的作用机制、疗效评价以及不良反应等。     

液氮冷冻联合5-氨基酮戊酸光动力疗法治疗肛周尖锐湿疣的疗效观察

肛周尖锐湿疣有多发、易复发、疣体巨大等特点,临床治疗尤为棘手,传统的治疗方法包括冷冻、激光及外用细胞毒药物等的复发率偏高.吕萍[1]统计的CO2激光治愈率为26.31％,复发率50％.任雁威等[2]的研究表明,单纯液氮冷冻治疗的复发率为40％.近几年来,随着5-氨基酮戊酸光动力疗法(ALA-PDT)的广泛应用,尖锐湿疣的治疗有了新的突破,它具有靶向性治疗,复发率低,不良反应少等优点,但治疗次数多,费用较高,尤其对于疣体较大、较多的部位疣体清除率低.为了更好的降低复发率最大程度减少治疗次数,本研究组于2010年4月-2011年5月对光动力联合液氮冷冻治疗肛周尖锐湿疣进行了较为细致的比较研究,现将结果报告如下.     

Successful treatment of periungual warts using photodynamic therapy: a pilot study

AIM: The aim of this pilot study was an investigation on photodynamic therapy (PDT) whether it is a good alternative for treating periungual and subungual warts of the hands. STUDY DESIGN: Twenty patients (mean age: 30.5 years) with a total of 40 periungual and subungual warts were treated with PDT. A photosensitizer, 20%delta-aminolevulinic acid was applied on the warts. After a mean incubation time of 4.6 h (SD: 1.2), the warts were irradiated with the VersaLight for 5-30 min (15.2 +/- 4.3 min). RESULTS: After a mean of 4.5 treatments a mean clearance of 100% was achieved in 90% of the patients. One patient (5%) showed a clearance of 50% and another showed no improvement. The subungual or periungual location of the wart had no influence on the number of treatments or end result (P > 0.05). There were two recurrences during the mean follow-up period of 5.9 months (SD: 7.6). Besides mainly pain and hyperpigmentation, most treatments had no side-effects. CONCLUSION: PDT can offer a good alternative for treating periungual warts of the hands. Larger studies are indicated.     

Successful treatment of periungual warts with topical cidofovir

Periungual warts represent a treatment challenge because of its high recurrence rate and recalcitrance. These are benign lesions produced by the human papilloma virus (HPV) that often do not respond to habitual treatment. Cidofovir is a potent antiviral drug that acts inactivating viral DNA polymerase. Topical cidofovir for the treatment of HPV‐related cutaneous and mucous lesions is becoming increasingly common. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral periungual warts. We undertook a retrospective observational study of patients with periungual warts who received treatment with topical cidofovir between January 2010 and December 2013 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data were recorded about the rate of treatment response, the adverse effects and recurrences, as well as the characteristics of the patient cohort. We identified 41 patients who had received some previous treatment. The concentration of cidofovir was 3% in all cases, usually applied twice a day (in 37 of the 41 cases). A greater or lesser response was noted in 35 cases. There were six recurrences in the follow‐up period. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant periungual common warts that fail to respond to usual treatment. Our experience with the use of this antiviral agent has been satisfactory, although in our opinion, it should be reserved for specific cases as its economical cost represents an important limitation.     

光动力疗法联合冷冻治疗外阴脂溢性角化病一例

<正>临床资料患者,女,49岁。主因右侧大阴唇外侧褐色斑块7年余,于2014年3月1日就诊。患者7年前发现右侧大阴唇外侧一处黄豆大小褐色丘疹,表面粗糙,伴轻度瘙痒,未予诊治,丘疹逐渐增大为斑块。近1个月来,斑块增长速度较快,表面凹凸不平,无破溃。患者既往体健,否认有非婚性行为史。体格检查:一般情况好,心、肺、腹检查无明显异常,全身浅表淋巴结未及增大。皮肤科情况:右侧大阴唇外侧可见一4 cm×3 cm大小     

Comparison of photodynamic therapy with cryotherapy in the treatment of Bowen's disease

Summary The efficacy and suitability of photodynamic therapy (PDT) was compared with that of cryotherapy in the treatment of 40 lesions of Bowen's disease. Lesions were randomized to receive either cryotherapy with liquid nitrogen, or PDT using a portable desktop lamp incorporating a 300 W xenon short arc discharge source. A porphyrin precursor, 5-aminolaevulinic acid (5-ALA), was applied topically 4 h before irradiation in the PDT group. Each lesion received 125J/cm² at a fluence rate of 70mW/cm². All patients were reviewed at 2-monthly intervals and treatments repeated if required. Cryotherapy produced clearance in 10 of 20 lesions after one treatment, the remaining 10 lesions requiring two or three treatment applications. PDT resulted in clearance of 15 of 20 lesions after one treatment and of the remaining five lesions after a second treatment. The probability that a lesion cleared after one treatment was greater with PDT than cryotherapy (P < 0.01). Cryotherapy was associated with ulceration (five of 20), infection (two of 20) and recurrent disease (two of 20): no such complications occured following PDT. PDT using a non-laser light source and topical 5-ALA appears to be at least as effective as cryotherapy in the treatment of Bowen's disease with fewer adverse effects.     

A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata

Background: Cryotherapy cannot destroy subclinical human papillomavirus‐infected cells of condylomata acuminata (CA). The topical application of aminolevulinic acid (ALA) results in a shallow penetration depth in CA lesions ( 1 ). Objectives: To compare the efficacy and safety of cryotherapy plus ALA‐photodynamic therapy (PDT) with cryotherapy in the treatment of multiple CA. Methods: Eighty patients with multiple CA received cryotherapy plus ALA‐PDT (n=40) or cryotherapy plus placebo‐PDT (n=40). After cryotherapy, a 20% ALA or a placebo solution was applied to the CA area 3 h before illumination with red light (635 nm, 100 mW/cm², 100 J/cm²). The treatment was repeated 7 days after the first treatment if the lesions were not completely resolved. The complete response rate, recurrence rate and adverse effects in the two groups were analyzed. Results: After two treatments, the complete response rates in the combined group (cryotherapy plus ALA‐PDT) and cryotherapy group were 32.4% (36/111) and 32.6% (43/132) in the anal area (P>0.05), 100% (32/32) and 54.5% (18/33) in the urethral meatus (P<0.05), and 94.2% (129/137) and 50.5% (56/111) in the external genitals (P<0.05), respectively. The recurrence rates in the combined group and cryotherapy group were 24.3% (27/111) and 31.1% (41/132) in the anal area (P>0.05), 9.4% (3/32) and 39.4% (13/33) in the urethral meatus (P<0.05), and 3.6% (5/137) and 31.5% (35/111) in the external genitals (P<0.05), respectively. The adverse effects in each group included mild to moderate pain, edema, erosion and hypopigmentation, without any infection, ulcers, scarring or urethral malformations. Conclusion: Cryotherapy plus ALA‐PDT is a more effective regimen for the treatment of multiple CA compared with cryotherapy alone.     

冷冻或外用药物联合光动力疗法治疗肛管内尖锐湿疣疗效观察

目的观察局部冷冻或外用药物联合光动力治疗肛管内尖锐湿疣(CA)的疗效。方法采用局部冷冻或外用药物联合光动力治疗51例肛管内CA患者,光动力疗法7~10 d治疗1次,共2~5次。于治疗结束后2、4、8、12周对疣体完全清除者进行随访,观察治疗情况。结果 51例患者中47例疣体完全清除,疣体清除率为92.16%(47/51),其中41例痊愈,治愈率为87.23%(41/47)。随访疣体完全清除者中4例在治疗后8周复发,2例在12周内复发,复发率为12.77%(6/47)。结论局部冷冻或外用药物联合光动力治疗肛管内CA安全、有效。     

液氮冷冻联合氨基酮戊酸光动力疗法治疗尖锐湿疣的系统分析

尖锐湿疣（CA）是由人乳头瘤病毒感染引起的一种常见的性传播疾病,常用液氮冷冻、CO2激光等物理治疗祛除疣体,但治疗后易复发。氨基酮戊酸光动力疗法（ALA-PDT）是一种通过外擦光敏剂配合激光照射,选择性破坏病变组织的疗法。国产盐酸氨基酮戊酸在皮肤科主要用于尖锐湿疣的治疗［1］,现已有不少液氮冷冻联合ALA-PDT治疗尖锐湿疣的报道,为进一步了解这两种方法联合治疗尖锐湿疣的有效性和安全性,我们用Meta分析方法,对液氮冷冻联合ALA-PDT治疗尖锐湿疣的临床报告进行系统评价,旨在为临床治疗尖锐湿疣提供决策依据……