{"title":"Porokeratosis ptychotropica and concurrent condyloma acuminata respond well to photodynamic therapy","authors":"Patrick Jui-Hui Peng , Chung-Hsing Chang","doi":"10.1016/j.pdpdt.2025.104582","DOIUrl":null,"url":null,"abstract":"<div><div>Porokeratosis ptychotropica (PPt), a rare variant of porokeratosis, occurs predominantly in the gluteal cleft, buttocks, perineum, and genitals. Here we present the case of a 73-year-old man with patchy hyperkeratotic lesions and verrucous growths over his buttocks, perianal area, gluteal cleft, and scrotum, which result in an uncomfortable moist sensation over his anus. Skin biopsies of all lesions revealed a combination of cornoid lamellae, koilocytes, and P16 focal-positive immunohistochemistry, indicating condyloma acuminata overlying the PPt.</div><div>A standardized and effective treatment regimen for porokeratoses is currently lacking. PDT treats a variety of conditions by inducing oxidative stress and enhancing local immunity, and offers a benefit for perianal lesions due to its preservation of anal sphincter function.</div><div>Three monthly topical photodynamic therapy (PDT) sessions with 78 mg/g 5-aminolevulinic acid (5-ALA) gel and 635 nm red light (total 78 J/cm<sup>2</sup>) were performed over the patient's perianal and buttock region, and two monthly PDT sessions were performed over his scrotum. 405 nm blue light was used to visualize 5-ALA bioutilization via protoporphyrin IX fluorescence before each session. At 2-month follow-up, the patient reported significant clinical and symptoms improvement, and remains symptom-free at 6-months follow-up. This represents the first report of concurrent PPt and CA. We hope to demonstrate the versatility of PDT and expand its list of indications, and demonstrate that, while PPt and concurrent CA is challenging to treat, PDT may offer an alternative therapeutic option.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"53 ","pages":"Article 104582"},"PeriodicalIF":2.6000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodiagnosis and Photodynamic Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1572100025001115","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Porokeratosis ptychotropica (PPt), a rare variant of porokeratosis, occurs predominantly in the gluteal cleft, buttocks, perineum, and genitals. Here we present the case of a 73-year-old man with patchy hyperkeratotic lesions and verrucous growths over his buttocks, perianal area, gluteal cleft, and scrotum, which result in an uncomfortable moist sensation over his anus. Skin biopsies of all lesions revealed a combination of cornoid lamellae, koilocytes, and P16 focal-positive immunohistochemistry, indicating condyloma acuminata overlying the PPt.
A standardized and effective treatment regimen for porokeratoses is currently lacking. PDT treats a variety of conditions by inducing oxidative stress and enhancing local immunity, and offers a benefit for perianal lesions due to its preservation of anal sphincter function.
Three monthly topical photodynamic therapy (PDT) sessions with 78 mg/g 5-aminolevulinic acid (5-ALA) gel and 635 nm red light (total 78 J/cm2) were performed over the patient's perianal and buttock region, and two monthly PDT sessions were performed over his scrotum. 405 nm blue light was used to visualize 5-ALA bioutilization via protoporphyrin IX fluorescence before each session. At 2-month follow-up, the patient reported significant clinical and symptoms improvement, and remains symptom-free at 6-months follow-up. This represents the first report of concurrent PPt and CA. We hope to demonstrate the versatility of PDT and expand its list of indications, and demonstrate that, while PPt and concurrent CA is challenging to treat, PDT may offer an alternative therapeutic option.
期刊介绍:
Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.