Combined ablative fractional Er∶YAG laser and 10% ALA-PDT in treatment of refractory verruca plana

Abstract

Objective To evaluate the efficacy of combined therapies of ablative fractional Er∶YAG laser (2, 940 nm) and ALA-PDT on refractory verruca plana. Methods 120 cases of refractory verruca plana patients were randomly divided into two groups: 60 cases in the control group and 60 cases in the experimental group. The control group used 10% ALA-PDT with LED irradiation of a power density 70 of mW/cm2 at a distance of 20 cm, which lasted for 20 min each time. The experimental group was treated with ablative fractional Er∶YAG laser (2, 940 nm) first with the fluence of 500P/cm2 and short pulse duration, and then treated 10% ALA-PDT as mentioned before. Every patient was treated twice at two-week intervals. Three independent investigators evaluated subject outcomes at 3 months post-treatment including efficacy and side-effects. Results The effective rate of the experimental group was 86.44% at 3 months post-treatment after one to two times. Meanwhile, the control group was 59.65%. The clinical outcome of experimental group was better than the control group. There was significant difference between the two groups (P<0.05). The recurrent rate of experimental group was 3.39% and 12.30% in control group. There was significant difference between the two groups (P<0.05). There were no obvious side-effects in both groups. Conclusions Ablative fractional laser with low fluence promotes the transdermal absorption of ALA and enhances the efficacy of PDT. Key words: Fractional ablative laser; Photodynamic therapy; Verruca plana; Aminolevulinic acid