الفهرس 
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Abstract
Warts are benign epidermal lesions caused by human papillomavirus (HPV). Papillomaviruses are a large group of DNA viruses that can widely affect humans and animals with more than 150 genotypes that infect the epithelia of skin or mucosa most commonly inducing benign papillomas or warts.
Treatment for HPV infection is generally unsatisfactory. Most rely on destruction of affected tissue. Clinically normal skin may harbor viral DNA and, thus, it is unlikely that destroying visible lesions eliminates the virus.
Photodynamic therapy (PDT) destroys HPV- infected keratinocytes and inactivates non- enveloped viral particles by the possible mechanism of binding photosensitizer (PS) molecules to the viral surface glycoproteins and inhibiting early phases of viral infection. Intense pulsed (IPL) alone can be used in wart treatment by selective destruction of superficial capillaries and thermal damage to the heat sensitive HPV.
Methylene blue is a widely known histological dye that has been in use for many years. It belongs to the phenothiazinium class of compounds. The characteristic colour of MB is caused by the strong absorption band in the 550-700nm region with peak absorption at 664 nm. Hence, using methylene blue as a PS prior to IPL increases the light absorption at target skin area and selectively intensifying the photochemical reaction in the treated area.
Therefore, this study aimed to assess the efficacy (clinically and dermoscopically) and safety of photodynamic therapy using intralesional injection of 4% methylene blue solution as a photosensitizer with IPL versus IPL only in treatment of warts.
The presented study included eighty patients with clinically and dermoscopically diagnosed verrucae. Patients were randomized using a closed envelope into 3 groups: group A (30 patients) MB-IPL-PDT group, group B (30 patients) IPL group & group C (20 patients) control group.
The results of the present study revealed that the calculated cure rate was significantly higher for group A (40.9%) than that of group B (23.4%). Whereas the control group did not show any response.
ImageJ analysis revealed significant gradual reduction in both surface area of wart (80.05 % for group A compared to 48.16 % for group B) and surface area of vessels and hemorrhagic dots (89.28 % for group A compared to 65.99 % for group B) favoring MB-IPL-PDT. It was observed that the vessels and hemorrhagic dots are more affected than the size of wart in both groups.