Porokeratosis ptychotropica and concurrent condyloma acuminata respond well to photodynamic therapy

IF 2.6 3区 医学 Q2 ONCOLOGY
Patrick Jui-Hui Peng , Chung-Hsing Chang
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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.
色差性角化孔症和并发尖锐湿疣对光动力疗法反应良好
偏右性角化孔症(PPt)是一种罕见的角化孔症,主要发生在臀沟、臀部、会阴和生殖器。我们在此报告一位73岁男性的病例,他的臀部、肛周、臀沟和阴囊有斑状角化过度病变和疣状生长,导致肛门有不舒服的潮湿感觉。所有病变的皮肤活检显示角膜片状,角质细胞和P16局灶性阳性免疫组化,提示尖锐湿疣覆盖在PPt上。目前缺乏标准化和有效的角化孔病治疗方案。PDT通过诱导氧化应激和增强局部免疫来治疗多种疾病,并因其保留肛门括约肌功能而对肛周病变有益。用78 mg/g 5-氨基乙酰丙酸(5-ALA)凝胶和635 nm红光(总78 J/cm2)对患者肛周和臀部区域进行三个月的局部光动力治疗(PDT),对其阴囊进行两个月的PDT治疗。每次疗程前,用405 nm蓝光通过原卟啉IX荧光观察5-ALA的生物利用情况。在2个月的随访中,患者报告了显着的临床和症状改善,并在6个月的随访中保持无症状。这是首次报道PPt和CA同时发生。我们希望证明PDT的多功能性,扩大其适应症列表,并证明PPt和并发CA的治疗具有挑战性,而PDT可能提供另一种治疗选择。
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来源期刊
CiteScore
5.80
自引率
24.20%
发文量
509
审稿时长
50 days
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.
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