Condyloma acuminatum is one of the most common STDs in dermatology 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. Warts are caused by human papilloma virus (HPV) infection of the skin mucosa.
The traditional treatment methods are: 1, local freezing treatment; 2, local carbon dioxide laser treatment (or electrocautery, electrocautery treatment); 3, local topical drug treatment; 4, other auxiliary treatment. Cryotherapy costs less for a single session (50-100 yuan), and the treated wound is superficial, heals quickly, and is less likely to have scarring, but the recurrence rate is greater than 50%. Carbon dioxide laser treatment is much more expensive than cryotherapy ($100-$1,000) and requires local anesthesia. The recovery of the treated wound is a little slower and sometimes scarring can occur. Although topical topical medication can eliminate the need for a hospital visit, it often causes local redness and swelling due to the method of use or improper selection of medication. Adjuvant treatments such as intramuscular interferon, intravenous interleukin, and intravenous antiviral drugs are very costly, and the effectiveness of treatment varies greatly from person to person, and some treatments are very controversial. Therefore, in terms of adjuvant treatment at Peking Union Medical College Hospital, only a small percentage of patients with recurrent relapses are treated with adjuvant therapy with intramuscular interferon, and the other two treatments are not applied. In many irregular hospitals, the cart is often put before the horse, making patients spend a lot on adjuvant therapy and over-exaggerating the role of adjuvant therapy.
With the development of medical technology, we have a new treatment for condyloma acuminata, which is recently widely used in the clinic PhotodynamicTherapyPDT.
I. Treatment principle of photodynamic therapy.
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 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 treatment purpose.
Photodynamic therapy indications.
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, common acne.
Three, the steps of photodynamic therapy.
1.Fresh medicinal solution will be prepared by the medical staff as it is used for 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 reactions of photodynamic therapy.
The most common adverse reactions are localized pins and needles pain, 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 obvious pain, topical “compound lidocaine cream” can be applied locally or the doctor should be notified for further special treatment.
V. Cost of treatment
1, the cost of drugs: aminoglutaric acid hydrochloride (Ala, ALA) each drug 863 yuan, the general area is not very large acromegaly patients, each treatment using 1.
2, the cost of treatment; each time 300 yuan, usually local light time is 20 minutes.
3, usually treated once a week, about half a day; 2-3 times for a course of treatment.
Six, photodynamic therapy precautions.
1, it is recommended to use carbon dioxide laser or freezing first, after removing the obvious warts visible to the naked eye, in 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 condyloma acuminata (such as warts occurring in the urethra, urethra, vulva around the opening of the glands) can be directly selected photodynamic therapy.
3, after local carbon dioxide laser or freezing treatment, recurring patients, it is recommended that local photodynamic therapy 2-3 times.
4.After conventional traditional treatment, photodynamic therapy can be chosen 2-3 times for consolidation treatment to prevent recurrence.
5, any kind of treatment currently can not absolutely prevent the recurrence of condyloma acuminata, general photodynamic therapy 3 times after the wart recurrence rate of less than 10%.