Abstract

The purpose of this pilot study was to determine if photodynamic therapy with topical application of 5‐aminolaevulinic acid followed by irradiation with incoherent filtered and unfiltered light (ALA‐PDT) is an effective therapy for recalcitrant hand and foot warts. In 30 patients with recalcitrant warts, 49 regions with a total of 250 warts were randomized to one of the following five treatments: (i) ALA‐PDT with white light applied three times within 10 days (W3); (ii) ALA‐PDT with white light applied once (W1); (iii) ALA‐PDT with red light applied three times within 10 days (R3); (iv) ALA‐PDT with blue light applied three times within 10 days (B3), and (v) cryotherapy applied up to four times within 2 months (CRYO). The ALA‐PDT treatment modality was repeated in case of partially responding warts. Significantly more warts were completely healed after W3 and W1 than after R3, B3 and CRYO (P < 0.01): 73% of the warts treated with W3 were completely healed, 71% after W1, 42% after R3, 23% after B3 and 20% after CRYO. No scars were observed in the ALA‐PDT treated areas and patients treated for foot warts were all able to walk after the treatment. No recurrences in completely responding ALA‐PDT treated warts were observed after 12 months of follow‐up. In conclusion, photodynamic therapy with topical 5‐aminolaevulinic acid followed by irradiation with white light is a promising treatment for recalcitrant hand and foot warts.

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