Clinical efficacy of CO2 laser combined with 5-aminolevulinic acid photodynamic therapy in treating periungual and plantar warts.

Objective: To analyze the clinical application value of CO₂ laser combined with 5-aminolevulinic acid photodynamic therapy for periungual and plantar warts.

Methods: Data from patients with periungual and plantar warts treated at Qingpu branch of Zhongshan Hospital, Fudan University between August 2022 and January 2024 were retrospectively analyzed. After screening based on inclusion and exclusion criteria, 96 patients were included and categorized into two groups according to their treatment regimens: a combination group (n=50, receiving CO₂ laser therapy and 5-aminolevulinic acid photodynamic therapy) and a control group (n=46, undergoing CO₂ laser treatment alone). The two groups were compared in terms of wart scores before and after treatment, clinical efficacy, recurrence rates during follow-up, and incidence of adverse reactions.

Results: During the 4th, 6th, and 8th weeks of treatment, the wart scores of patients in the combination group were significantly lower than those of the control group (P<0.05), and at these intervals, the overall treatment efficacy in the combination group was significantly higher than that of the control group (P<0.05). At 3-month follow-up, the recurrence rate in the combination group (2.00%) was lower than that in the control group (10.87%) (P<0.05). At the 2nd, 4th, 6th, and 8th weeks of treatment, the Visual Analog Scale scores in the combination group were significantly reduced compared to the control group (P<0.05). No significant difference was found in the incidence of adverse reactions between the two groups during follow-up (P>0.05).

Conclusion: The application of CO₂ laser therapy combined with 5-aminolevulinic acid photodynamic therapy is effective for patients suffering from periungual and plantar warts, and this combination enhances clinical outcome, mitigates pain, and reduces short-term recurrence.