Photodynamic therapy with pretreatment for long duration recalcitrant cutaneous warts: huge verrucae vulgaris, periungual warts and plantar warts

To study the effectiveness and safety of photodynamic therapy for huge verrucae vulgaris, and plantar warts, three types of cutaneous warts with long druration. Three cases of recalcitrant cutaneous warts with multiple lesions which diagnosed as huge verrucae vulgaris, periungual warts and plantar warts with the duration of 10 years, 6years and 8years, separately were included and treated with ALA-PDT. Singel fractional CO2 laser, scraping with the lancet, fractional CO2 laser or combine were performed each time before PDT. After 2 treatments, 4 treatments, and 9 treatments separately, the cases of huge verrucae vulgaris, periungual warts and plantar warts got excellent response or complete response . ALA-PDT is safe and effective for long duration recalcitrant huge verrucae vulgaris, periungual warts and plantar warts, adequate pretreatment, proper interval and good patient compliance are important.