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Background and Objective To evaluate the efficacy and cosmetic outcome of holmium laser combined with photodynamic therapy in the treatment of patients with bowenoid papulosis(BP) lesions that were challenging to conventional therapy.Methods: Eight Chinese patients with BP (5 males and 3 females) were enrolled in the study.After ablated lesion with holmium laser, baseline surface of lesion was applied with 20% of 5-Aminolevulinic Acid under occlusive dressing with a 2 mm normal skin margin for 3.5 hours,and then illuminated by a 635-nm laser for 20 min with energy 100J/cm2.Two sessions of treatment were performed in each patient with interval 10-14 days, repeat treatment continued until no doubtful lesion was seen at follow up time.The clinical and cosmetic response were initially evaluated in the last follow-up.Results: Complete clinical recovery was attained from all 8 patients with an excellent cosmetic outcome in 12-48 months follow-up visit.Patients were tolerant enough, there was no need for discontinuation of treatment for any patient.Two patients with immunosuppressive status relapsed in the last follow up.Coneltsions:Holmium laser combined with photodynamic therapy in the treatment of patients with BP exhibited high efficiency and excellent cosmetic outcome, but could be relapse in some patients.