title: Therapeutic effects of topical 5-aminolevulinic acid photodynamic therapy.
abstract: OBJECTIVE
  To evaluate the therapeutic effects of combined 5-aminolevulinic acid (ALA) and photodynamic therapy (PDT) on genital warts and the safety.
  
  
  METHODS
  One hundred ten patients with genital warts who were treated in our hospital from June 2013 to October 2014 were selected. The warts and affected parts were disinfected with benzalkonium bromide solution, and the warts were covered with absorbent cotton that had already been added freshly prepared 20% ALA solution, packaged and fixed. Then they were wet-dressed in dark, into which ALA solution was added according to the proportion of 5:3:2 every 30 minutes for three consecutive hours. Afterwards, the warts were illuminated by using photodynamic laser apparatus. The clinical outcomes, adverse reactions and recurrence rates were observed.
  
  
  RESULTS
  Genital warts were relieved in 107 out of the 110 cases (cure rate: 97.3%). Male patients had significantly better treatment outcomes at the urethral orifice than those in other affected parts. In the 107 patients, the cure rate of male patients was 98.8%, and they were cured after being treated four times. In contrast, female patients, who were cured after 5 times of treatment, had the cure rate of 91.7%. Their cure rates were similar (χ(2)=0, P>0.05), but the males were cured after significantly fewer times of treatment than the females (t=-7.432, P<0.05). Five patients suffered from mild tingling or burning sensation upon dressing at the urethral orifice, and the others were all free from systemic adverse reactions. After illumination, a small portion of the patients had mildly red, swelling, painful affected parts, with mild edema that almost disappeared within three days. Three patients relapsed at the urethral orifice and were then cured after further treatment.
  
  
  CONCLUSIONS
  ALA-PDT can treat genital warts safely with high cure rate and low recurrence rate, particularly working for those of males at the urethral orifice.
authors.affiliation: Yin-E Hu, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China.
authors.forename: Yin-E
authors.initials: YE
authors.lastname: Hu
authors.affiliation: Shu-Fang Dai, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China.
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Dai
authors.affiliation: Bin Wang, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Wei Qu, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qu
authors.affiliation: Jun-Ling Gao, Department of Dermatology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan Province, China.
authors.forename: Jun-Ling
authors.initials: JL
authors.lastname: Gao
keywords: 5-aminolevulinic acid; Clinical therapeutic effect; Genital wart; Photodynamic therapy; Safety