{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T02:42:56Z","timestamp":1761619376213},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T00:00:00Z","timestamp":1397001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Photodynamic therapy with 5\u2010aminolevulinic acid (ALA\u2010PDT) offers promising results for the treatment of condyloma acuminatum. However, patients have to dwell with pain to benefit from this otherwise effective and safe \u201coff\u2010label\u201d treatment modality. Several techniques have been explored to control ALA\u2010PDT\u2010induced pain, but the desperate search for a universally accepted method is still ongoing. This study compares the two\u2010step irradiance approach with single\u2010dose administration of 100\u2009mg tramadol sustained\u2010release tablets for pain induced by ALA\u2010PDT of condyloma acuminatum in Chinese patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Adult Chinese patients with condyloma acuminatum were enrolled in a randomized comparative study. Pain levels were compared using the Numeric Rating Scale (NRS) at pre\u2010defined assessment points during and after irradiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pain was dominated by characteristics such as burning and pricking and was almost always local and superficial.<\/jats:p><\/jats:sec><jats:sec><jats:title>During Irradiation<\/jats:title><jats:p>The median pain scores were lower in the two\u2010step irradiance group at 1\u2009minute (<jats:italic>U<\/jats:italic>\u2009=\u2009621.5, <jats:italic>P<\/jats:italic>\u2009=\u20090.002) but higher at 20\u2009minutes (<jats:italic>U<\/jats:italic>\u2009=\u2009585.5, <jats:italic>P<\/jats:italic>\u2009=\u20090.002). The median pain scores between the two groups did not differ significantly at other assessment points. The pain was moderate in both groups and peaked earlier in the analgesics group (median: 5\u2009minutes) but later in the two\u2010step irradiance group (median: 15\u2009minutes).<\/jats:p><\/jats:sec><jats:sec><jats:title>After Irradiation<\/jats:title><jats:p>The pain was generally mild. The median pain scores were equal at each assessment point, except at 3\u2009hours where the median was lower in the analgesics group (1.0) as compared with the two\u2010step irradiance group (2.0) (<jats:italic>U<\/jats:italic>\u2009=\u2009725.0, <jats:italic>P<\/jats:italic>\u2009=\u20090.056).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pain in the two\u2010step irradiance protocol is irradiance\u2010dependent. The two\u2010step irradiance approach produces significant benefits over analgesics during the initial stages of therapy but analgesics offer significant benefits thereafter. There are potential benefits of combining the two approaches in minimizing ALA\u2010PDT\u2010induced pain. Lasers Surg. Med. 46:389\u2013395, 2014. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.22243","type":"journal-article","created":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T16:01:54Z","timestamp":1397059314000},"page":"389-395","source":"Crossref","is-referenced-by-count":9,"title":["Two\u2010step irradiance schedule versus single\u2010dose tramadol sustained\u2010release tablets for pain control during topical 5\u2010aminolevulinic acid\u2010photodynamic therapy of condyloma acuminatum in Chinese patients: A randomized comparative study"],"prefix":"10.1002","volume":"46","author":[{"given":"Uwesu O.","family":"Mchepange","sequence":"first","affiliation":[{"name":"Department of Dermatology Affiliated Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China"},{"name":"Department of Internal Medicine Mbeya Referral Hospital P.O. 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