5-Aminolevulinic acid-based photodynamic therapy used as a long-term management approach for refractory lichen sclerosus.
Yitao Qian, Wenjing Zha, Jie Shen et al.
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Case in brief
A 37-year-old man with more than 10 years of genital lichen sclerosus had recurrence after surgical resection, which left permanent anatomical deformity. Repeated courses of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) were given over five years. Symptoms and lesions were controlled after 13 initial sessions but recurred when ALA-PDT was stopped and topical halometasone was introduced. Further ALA-PDT courses brought the total to 41 sessions, with lesions regressing after each course. Adverse effects were mild and tolerable, with no severe events reported. No recurrence was noted during the one-year follow-up after the final course.
What made this case unusual
The report describes repeated ALA-PDT as a long-term approach for refractory male genital lichen sclerosus, with lesion regression after successive courses and no severe adverse events over five years.
Diagnostic / clinical pearl
In this case, recurrence followed discontinuation of ALA-PDT, while lesions regressed after subsequent courses; the reported response therefore occurred with repeated treatment rather than a single course.