Pediatric genital warts successfully treated with photodynamic therapy

Federica Li Pomi; Andrea d'Aloja; Antonio Di Tano; Mario Vaccaro; Francesco Borgia

doi:10.4081/dr.2024.9979

Authors

Federica Li Pomi Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy. https://orcid.org/0000-0001-6760-9468
Andrea d'Aloja Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Italy. https://orcid.org/0009-0008-5444-2054
Antonio Di Tano Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Italy.
Mario Vaccaro Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Italy.
Francesco Borgia
fborgia@unime.it
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Italy.

Genital warts (GWs) are the most common sexually transmitted infections worldwide, caused by the human papillomavirus (HPV). In adults, the primary mode of transmission is through sexual contact, whereas in children it can occur through skin-to-skin or skin-to-mucosa contact and be sexual or non-sexual. The increasing prevalence of GWs in children has renewed the interest in therapeutic management which still presents a unique challenge, being influenced by many variables including size, quantity, and location of warts, as well as the presence of comorbidities. Photodynamic therapy (PDT) has already shown encouraging results in treating viral warts in adult patients, but its use is still not standardized in the pediatric population. On this topic, we report the case of an otherwise healthy 5-year-old child affected by GWs, successfully treated with three sessions of PDT with 10% 5-aminolaevulinic acid (ALA), at one-month intervals. Our case is paradigmatic of the potentiality of PDT to treat difficult lesions in a pediatric setting.

Petca A, Borislavschi A, Zvanca M, et al. Non-sexual HPV transmission and role of vaccination for a better future (Review). Exp Ther Med. 2020;20:1-1. DOI: https://doi.org/10.3892/etm.2020.9316

Jayasinghe Y. Genital warts in children: what do they mean? Arch Dis Child. 2006;91:696-700. DOI: https://doi.org/10.1136/adc.2005.092080

Khayargoli P, Niyibizi J, Mayrand MH, et al. Human Papillomavirus Transmission and Persistence in Pregnant Women and Neonates. JAMA Pediatr. 2023;177:684. DOI: https://doi.org/10.1001/jamapediatrics.2023.1283

Syrjanen S, Puranen M. Human Papillomavirus Infections in Children: the Potential Role of Maternal Transmission. Critical Reviews in Oral Biology & Medicine. 2000;11:259-274. DOI: https://doi.org/10.1177/10454411000110020801

Di Bartolomeo L, Altavilla D, Vaccaro M, et al. Photodynamic therapy in pediatric age: Current applications and future trends. Front Pharmacol. 2022;13. DOI: https://doi.org/10.3389/fphar.2022.879380

Li Pomi F, Macca L, Peterle L, et al. Photodynamic therapy for intergluteal warts in a child affected by Rett syndrome. Photodiagnosis Photodyn Ther. 2023;42:103620. DOI: https://doi.org/10.1016/j.pdpdt.2023.103620

Shen S, Feng J, Song X, et al. Efficacy of photodynamic therapy for warts induced by human papilloma virus infection: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther. 2022;39:102913. DOI: https://doi.org/10.1016/j.pdpdt.2022.102913

Morton CA, Szeimies R ‐M., Basset‐Séguin N, et al. European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 2: emerging indications – field cancerization, photorejuvenation and inflammatory/infective dermatoses. Journal of the European Academy of Dermatology and Venereology. 2020;34:17-29. DOI: https://doi.org/10.1111/jdv.16044

Xie F, Yu HS, Wang R, et al. Photodynamic Therapy for Genital Warts Causes Activation of Local Immunity. J Cutan Med Surg. 2019;23:370-379. DOI: https://doi.org/10.1177/1203475419838548

Wang XL, Wang HW, Wang HS, et al. Topical 5-aminolaevulinic acid-photodynamic therapy for the treatment of urethral condylomata acuminata. British Journal of Dermatology. 2004;151:880-885. DOI: https://doi.org/10.1111/j.1365-2133.2004.06189.x

Giomi B, Pagnini F, Cappuccini A, et al. Immunological activity of photodynamic therapy for genital warts. British Journal of Dermatology. 2011;164:448-451. DOI: https://doi.org/10.1111/j.1365-2133.2010.10089.x

Macca L, Li Pomi F, Custurone P, et al. Photodynamic therapy for pediatric genital warts: A case report. Dermatol Ther. 2022;35. DOI: https://doi.org/10.1111/dth.15313

Borgia F, Giuffrida R, Coppola M, et al. Successful photodynamic therapy in a pediatric patient with difficult warts. Dermatol Ther. 2020;33. DOI: https://doi.org/10.1111/dth.13391

Borgia F, Giuffrida R, Coppola M, et al. Efficacy and safety of conventional versus daylight photodynamic therapy in children affected by multiple facial flat warts. Photodiagnosis Photodyn Ther. 2020;31:101819. DOI: https://doi.org/10.1016/j.pdpdt.2020.101819

Borgia F, Coppola M, Giuffrida R, et al. Excellent cosmetic result of daylight photodynamic therapy for facial flat warts in a child. Photodiagnosis Photodyn Ther. 2019;26:27-28. DOI: https://doi.org/10.1016/j.pdpdt.2019.02.021

Li Pomi F, Peterle L, Vaccaro M, et al. Daylight photodynamic therapy for cutaneous leishmaniasis in a pediatric setting: A case report and literature review. Photodiagnosis Photodyn Ther. 2023;44:103800. DOI: https://doi.org/10.1016/j.pdpdt.2023.103800

Shin JO, Son JH, Lee J, et al. Nonavalent human papilloma virus vaccine for the treatment of multiple recalcitrant warts: An open-label study. J Am Acad Dermatol. 2022;86:940-941. DOI: https://doi.org/10.1016/j.jaad.2021.03.074

Stringasci MD, Buzzá HH, de Arruda SS, et al. HPV condylomatosis region treated with multiple sessions of MAL-PDT: A case report. Photodiagnosis Photodyn Ther. 2020;31:101812. DOI: https://doi.org/10.1016/j.pdpdt.2020.101812

Borgia F, Giuffrida R, Caradonna E, et al. Early and Late Onset Side Effects of Photodynamic Therapy. Biomedicines. 2018;6:12. DOI: https://doi.org/10.3390/biomedicines6010012

Prayogo SA, Andrew H, Cong S, et al. Photodynamic therapy in the treatment of condyloma acuminata: A systematic review of clinical trials. Int J STD AIDS. 2023;34:76-86. DOI: https://doi.org/10.1177/09564624221138351

Li Pomi, F., d’Aloja, A., Di Tano, A., Vaccaro, M., & Borgia, F. (2024). Pediatric genital warts successfully treated with photodynamic therapy. Dermatology Reports. https://doi.org/10.4081/dr.2024.9979