Photodinamic therapy with toipical aminolevulinic acid for the treatment of plantar warts

Aim. treatment currently employed for plantar warts (PW) are often painfl and poorly effective. This study evaluates the effect of photodynamic therapy (PDT) with δ-aminolevulinic acid (ALA) on PW. Methods. Before treatment, the superficial hyperkeratotic layer of warts was removed by the application, for 7 days, of an ointment containing 10% urea and 10% salicylic acid. Then, after gentle curettage, a cream containing 20% ALA was applied under occlusive dressing for 3h on 3 patients with 84 warts, while 30 patients with 62 warts (controls) receveid only base cream. Both groups were irradiated using a visible light lamp (range 400-700 n, peaking at 630 nm). The light dose was 50 J/cm2 each session. Patients were followed-up for 12 months. During the treatemtn some patients referred mild burning sensation or slight pain. The absorption of ALA in warts was investigated and demonstrated by in vivo fluorescence spectroscopy. Results. Two months after the last irradiative session, 84.5% of the ALA-PDT treated lesions and 22.5% of controls had resolved. Conclusions. The results of this study suggest that topical ALA-PDT can be considered as alternative treatment for PW.