ALA-PDT used as a long-term management approach for refractory lichen sclerosus

Lichen sclerosus (LS) is a chronic and refractory inflammatory disease that can cause significant discomfort and deformities. The frequent recurrence of lesions underscores the need for effective long-term management strategies. The patient received 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT). A young male patient with over a decade of refractory genital LS was treated with ALA-PDT following recurrence after surgery. After 13 sessions of ALA-PDT, the symptoms and lesions were well-controlled. However, lesions recurred when treatment was discontinued and switched to topical therapy. Subsequent courses of ALA-PDT repeatedly achieved lesion regression with great improvement of penile skin and no significant adverse effects observed. ALA-PDT is a safe and effective long-term management option for male genital LS, providing sustained symptom control and lesion regression with minimal side effects.