Photodynamic therapy combined with laser drilling successfully prevents the recurrence of refractory oral proliferative verrucous leukoplakia.

Abstract

Oral proliferative verrucous leukoplakia is a potentially malignant disorder with high rates of recurrence and malignant transformation. Proliferative verrucous leukoplakia is often refractory to various treatments, including topical drugs, surgical resection, cryotherapy, and laser therapy. Topical 5-aminolevulinic acid-mediated photodynamic therapy is an innovative and effective treatment for potentially malignant oral disorders and has the potential to control the recurrence of precancerous lesions and cancer. Various pre-treatments or combined therapies have been proposed to increase the efficacy of topical 5-aminolevulinic acid-mediated photodynamic therapy, especially for large, thick, or highly keratinised lesions. We report a case of refractory proliferative verrucous leukoplakia in a 58-year-old female patient who showed rapid recurrence within 1 week of topical 5-aminolevulinic acid-mediated photodynamic therapy despite pre-treatment with microneedle puncture, combined intralesional injection of 5-aminolevulinic acid, and shortened treatment interval. We applied three sessions of topical 5-aminolevulinic acid-mediated photodynamic therapy combined with diode laser drilling pre-treatment at 1-week intervals, which successfully eradicated the lesions without any adverse effects and without any signs of recurrence at the 10-month follow-up. Topical 5-aminolevulinic acid-mediated photodynamic therapy combined with diode laser drilling pre-treatment is safe and well-tolerated and could have synergistic efficacy against refractory oral proliferative verrucous leukoplakia.

• Authors: Fei Wang, Yujie Shi, Yunmei Dong, Tiannan Liu, Hongxia Dan, Jiongke Wang, Xin Zeng
• Journal: Photodiagnosis and photodynamic therapy (Photodiagnosis Photodyn Ther) Vol. 36 Pg. 102564 (Dec 2021) ISSN: 1873-1597 [Electronic] Netherlands
• PMID: 34610431 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021. Published by Elsevier B.V.

Chemical References

• Pharmaceutical Preparations
• Photosensitizing Agents

Topics

• Female
• Humans
• Laser Therapy
• Lasers
• Leukoplakia, Oral (drug therapy)
• Middle Aged
• Pharmaceutical Preparations
• Photochemotherapy (methods)
• Photosensitizing Agents (therapeutic use)