title: Photodiagnosis and treatment of condyloma acuminatum using 5-aminolevulinic acid and homemade devices.
abstract: 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 photodynamic 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 Ribeirão 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 PpIX photobleaching and the irradiance and fluence rate to optimize conducting the clinical trials, to improve the devices and therefore increase the treatment response.
authors.affiliation: Instituto de Física de São Carlos (IFSC/USP), Laboratório de Biofotônica, São Carlos, São Paulo, Brazil. nataliainada@ursa.ifsc.usp.br
authors.forename: Natalia Mayumi
authors.initials: NM
authors.lastname: Inada
authors.forename: Mardoqueu Martins da
authors.initials: MM
authors.lastname: Costa
authors.forename: Orlando C C
authors.initials: OC
authors.lastname: Guimarães
authors.forename: Elizeu da Silva
authors.initials: Eda S
authors.lastname: Ribeiro
authors.forename: Cristina
authors.initials: C
authors.lastname: Kurachi
authors.forename: Silvana Maria
authors.initials: SM
authors.lastname: Quintana
authors.forename: Wellington
authors.initials: W
authors.lastname: Lombardi
authors.forename: Vanderlei Salvador
authors.initials: VS
authors.lastname: Bagnato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D010778:Photochemotherapy / Q000295:instrumentation* / Q000379:methods; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid