Condyloma acuminatum is one of the common venereal diseases in the Division of Dermatologic Venereology and is mainly transmitted through direct sexual contact. However, it cannot be generalized, a small percentage of patients may be related to autoimmunity, for example, diabetic patients, tumor patients, elderly and frail patients; it may also be related to sanitary appliances or supplies, local use of sexual massage health appliances, etc. The human papilloma virus (HPV) infects the skin mucous membrane and causes warts.
The conventional treatment methods are
1, local cryotherapy;
2, local carbon dioxide laser treatment (or electrocautery, electrocautery, microwave therapy);
3, local topical drug treatment;
4, other auxiliary treatment. Cryotherapy costs less (104 yuan), and the wound is superficial, heals quickly and is not easy to have a scar, but the recurrence rate is greater than 50%. Carbon dioxide laser costs much more ($104-$1,000) for a single treatment than freezing, and the treatment requires local anesthesia, and the recovery of the treated wound is a little slower, sometimes with scar formation.
Although topical topical medication can eliminate the need for hospital visits, it often causes local redness and swelling because of the method of use or improper choice of medication. Adjunctive treatments such as intramuscular interferon, intravenous interleukin, and static antiviral drugs are very costly, and the effectiveness of treatment varies greatly from person to person, and some treatments are highly controversial.
With the development of medical technology, we have a new treatment for condyloma acuminata, which is recently widely used in the clinic Photodynamic Therapy (PDT).
I. Photodynamic therapy principle.
The photosensitizer is input into human body, and after a certain period of time, the lesion is irradiated with specific wavelength of light. Through a series of photochemical and photobiological reactions, monomorphic oxygen and/or free radicals are generated with the participation of molecular oxygen, which oxidize and destroy various biological macromolecules in tissues and cells, causing irreversible damage to the abnormal proliferating active cells and finally causing cell death to achieve the therapeutic purpose.
II. Indications for photodynamic therapy.
1. Pre-cancerous skin diseases and skin malignant tumors, such as solar keratosis, basal cell carcinoma, squamous carcinoma;
2. Treatment of non-malignant tumor skin diseases, such as acanthosis, vascular malformation, acne vulgaris.
III. Steps of photodynamic therapy
1. The fresh medicinal solution will be prepared by the medical staff for use in the treatment.
2, fresh solution wet compress the affected area for 3 hours, and according to the specific circumstances of the corresponding local sealing package.
3, red light irradiation lesion local, irradiation time is usually 20 minutes.
Fourth, the adverse effects of photodynamic therapy
The most common adverse reaction is localized pinprick-like pain when illuminated, which can be tolerated by most patients, or will be relieved later on their own, generally without special treatment. Patients should be instructed not to be overly nervous, and for those with obvious pain, topical application of “compound lidocaine cream” may be used or the doctor should be notified for further special treatment.
V. Treatment cost
1.The cost of drugs: Aminoglutaric acid hydrochloride (ALA) 825 yuan per drug
The general area is not very large (1cm * 1cm) acromegaly patients, each treatment using 1.
2, treatment cost; 144 yuan per light spot (Linyi People’s Hospital)
The general local lighting time is 20 minutes
3, usually 1 time per week treatment, about half a day; generally need to need 4-6 times. Urethral opening, cervical opening and in the anal canal may be more times (9 times).
VI. Precautions for photodynamic therapy.
1, it is recommended to completely remove the obvious warts visible to the naked eye first, after the choice of photodynamic therapy, so as to reduce the cost of treatment, but also to shorten the treatment time.
2, special parts of the warts (such as warts occurring in the urethra, urethra, vulva gland opening around) can be directly selected photodynamic therapy, but will extend the treatment time and times, if photodynamic therapy before the complete removal of warts, will shorten the corresponding time and course of treatment.
3, after local laser or freezing treatment, repeated recurrence of patients, it is recommended that local photodynamic therapy 3-4 times.
4, after conventional traditional treatment, you can choose photodynamic therapy 3-4 times to consolidate treatment and prevent recurrence.
5, any kind of treatment currently can not absolutely prevent the recurrence of condyloma acuminata, general photodynamic therapy 4-6 times after the wart recurrence rate of less than 5%, if necessary, you can extend the number of treatment.