CLINICAL STUDY OF ANOGENITAL CONDYLOMA ACUMINATA TREATMENT WITH PHOTODYNAMIC THERAPY: REPORT OF IMMUNOCOMPROMISED CONDITIONS

Photodynamic Therapy for Condyloma Acuminatum and Cervical Intraepithelial Neoplasia Grade I in a Young Female Patient with Systemic Lupus Erythematosus: A Case Report

Condyloma acuminatum (CA), commonly known as anogenital warts, is a prevalent sexually transmitted disease primarily caused by low risk human papillomavirus (HPV) types 6 and 11. This case report outlines the successful use of photodynamic therapy (PDT) to treat extensive condyloma acuminatum in a young female patient with systemic lupus erythematosus (SLE) undergoing immunosuppressive treatment. The patient also had cervical intraepithelial neoplasia grade I. Carbon dioxide laser treatment were initially used to remove some surface warts, followed by PDT, resulting in satisfactory outcomes. After seven sessions, the warty growths were successfully removed. Interdisciplinary collaboration, involving rheumatology, gynecology, and dermatology, facilitated comprehensive management. This case highlights the efficacy and safety of PDT in treating condyloma acuminatum and suggests its potential as an alternative treatment for young SLE patients with similar conditions.

5-aminolevulinic acid induced photodynamic reactions in diagnosis and therapy for female lower genital tract diseases

Since the patients suffering from female lower genital tract diseases are getting younger and younger and the human papilloma virus (HPV) infection is becoming more widespread, the novel non-invasive precise modalities of diagnosis and therapy are required to remain structures of the organ and tissue, and fertility as well, by which the less damage to normal tissue and fewer adverse effects are able to be achieved. In all nucleated mammalian cells, 5-Aminolevulinic acid (5-ALA) is an amino acid that occurs spontaneously, which further synthesizes in the heme biosynthetic pathway into protoporphyrin IX (PpIX) as a porphyrin precursor and photosensitizing agent. Exogenous 5-ALA avoids the rate-limiting step in the process, causing PpIX buildup in tumor tissues. This tumor-selective PpIX distribution after 5-ALA application has been used successfully for tumor photodynamic diagnosis (PDD) and photodynamic therapy (PDT). Several ALA-based drugs have been used for ALA-PDD and ALA-PDT in treating many (pre)cancerous diseases, including the female lower genital tract diseases, yet the ALA-induced fluorescent theranostics is needed to be explored further. In this paper, we are going to review the studies of the mechanisms and applications mainly on ALA-mediated photodynamic reactions and its effectiveness in treating female lower genital tract diseases.

Selective, broad-spectrum antiviral photodynamic disinfection with dicationic imidazolyl chlorin photosensitizers

The COVID-19 pandemic exposes our vulnerability to viruses that acquire the ability to infect our cells. Classical disinfection methods are limited by toxicity. Existing medicines performed poorly against SARS-CoV-2 because of their specificity to targets in different organisms. We address the challenge of mitigating known and prospective viral infections with a new photosensitizer for antimicrobial photodynamic therapy (aPDT). Photodynamic inactivation is based on local oxidative stress, which is particularly damaging to enveloped viruses. We synthesized a cationic imidazolyl chlorin that reduced by > 99.999% of the percentage inhibition of amplification of SARS-CoV-2 collected from patients at 0.2 µM concentration and 4 J cm-2. Similar results were obtained in the prevention of infection of human ACE2-expressing HEK293T cells by a pseudotyped lentiviral vector exhibiting the S protein of SARS-CoV-2 at its surface. No toxicity to human epidermal keratinocytes (HaCaT) cells was found under similar conditions. aPDT with this chlorin offers fast and safe broad-spectrum photodisinfection and can be repeated with low risk of resistance.

Photodynamic Therapy Used to Treat an HIV Patient with an Efflorescence of Viral Warts after HAART Therapy

Healing from viral warts lesions can be hard to achieve in immunocompromised subjects like HIV-positive patients. The therapeutic target in immunocompetent subjects can be reached using different methods, including topical ointments, cryotherapy, laser therapy, imiquimod, and photodynamic therapy (PDT). We present a case of a male HIV-positive patient who came to the Dermatology department with multifocal wart lesions on his face, auricular, and retro-auricular areas after treatment with highly active antiretroviral therapy (HAART). In our case, surprisingly, only one session of PDT proved to induce complete regression of lesions which, despite their thickness, had a much more robust response to treatment than we could have possibly expected. After a brief review of the literature, it is possible to state that PDT revealed itself to be a valid option in immunocompromised patients who have a major risk of relapse.

Clinical and histopathologycal study of actinic keratosis treatment with photodynamic therapy VS 5-fluorouracil in face cancerization field

Actinic keratosis (AK) is one of the most frequent pathologies in clinical practice. The prevalence varies according to the area of incidence and age. Approximately 10% of the prevalence of AK occurs at 30 years of age and rises to 80% at 70 years of life. This study conducted a split-face analysis based on Photodynamic Therapy (MALA-PDT) and 5-fluorouracil (5-FU) treatments in patients with AK. Clinical and histopathological studies evaluated each treatment's efficiency and side effects. Six patients were recruited between 50 and 70 years of age for this. MALA-PDT was applied on the right side of the face. A biodistribution time of 2 hours, a dose of light of 36 J / cm² (20 min irradiation), a spot for photoirradiation with a total area of 100 cm², and a wavelength of 635 nm were used. (LINCE equipment MMOPTICS-Brazil). By fluorescence diagnosis, clinical and subclinical AK lesions were evidenced in the area called the "cancerization field." Two cycles of MALA-PDT were performed on each patient, and 5-FU was applied twice daily for 15 days. A 2-month follow-up post-MALA-PDT and post-5-FU was carried out. The treatment based on 5-Flu and MALA-PDT clinically shows the same response, but MALA-PDT is less aggressive than 5-FU. The treatment of AK based on MALA-PDT is a practical, cheap, and easy-to-use technique.