Multimodal Treatment Approach for Giant Condylomata Acuminata Complicated by Lichen Sclerosus: A Case Report

• Treatment report on giant condylomata acuminata (CA) complicated by lichen sclerosus (LS) with extensive involvement of the glans penis and urethra. • A multimodal treatment strategy primarily utilizing ALA-PDT, assisted by Holmium-laser and curettage, is effective for refractory giant CA complicated by LS. • This case confirms the efficacy and long-term safety of ALA-PDT in treating such complex cases (e.g., CA complicated by LS), particularly when both diseases are responsive to ALA-PDT. A 65-year-old male presented with cauliflower-like growths on the penis for two years. Physical examination revealed erythema and cutaneous atrophy on the prepuce, glans, and external urethral meatus, with diffuse cauliflower-like proliferations on this basis. Based on the clinical and histopathological findings, a diagnosis of condylomata acuminata (CA) with concomitant lichen sclerosus (LS) was made. The patient received a multimodal treatment involving 5-aminolevulinic acid photodynamic therapy (ALA-PDT), Holmium-laser, and curettage, which led to significant improvement of the lesions. No recurrence was observed during a 4-year follow-up period.