Off label treatments of genital warts: the role of photodynamic therapy.

Conventional therapies for genital warts, the clinical expression of low-risk human papillomavirus (HPV) anogenital infection, are not targeted antiviral therapies, but either attempt physical removal of the lesion or induce inflammation and a bystander immune response. Moreover, very few of the current treatments have been tested by rigorous blinded, randomized controlled trials. Therefore, official recommendations are often associated with unsatisfactory response rates and high recurrence rates. It is the purpose of this review to provide a brief overview of the genital wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with this disease. Particular attention will be paid to unconventional and complementary therapies (the so called "off-label" treatments) among which photodynamic therapy has been recently introduced as a promising strategy to both guarantee clearance of the lesion and eradication of the virus itself. Mechanisms of action of PDT are discussed together with a summary of clinical and experimental available evidences.