Abstract
Dermatophytosis, paracoccidioidomycosis and sporotrichosis are mycoses caused by different fungal species with significant prevalence in Brazil and other countries. In some situations, they affect quality of life, especially in the most vulnerable populations. Antifungal drug therapy is the conventional treatment for these diseases, although some difficulties may occur. Adjunctive use of antimicrobial photodynamic therapy (aPDT) may reduce these challenges. Three patients were treated with aPDT and conventional antifungals. In all cases, the patients did not report pain, discomfort or side effects during or after the aPDT intervention. The adjunctive use of aPDT in the cases presented proved to be a safe, low-cost tool that may be promising for the treatment of different mycoses.
Plain language summary
Some fungal diseases are very common in Brazil and other countries and, in some cases, treatment may be difficult. The combination of a type of laser may help the treatment of these diseases. Here, three cases of fungal diseases that were treated with laser, dye and conventional antifungals are presented.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1. Clinical, epidemiological, and therapeutic profile of dermatophytosis. An. Bras. Dermatol. 89(2), 259–264 (2014).
- 2. Paracoccidioides brasiliensis PS2: first autochthonous paracoccidioidomycosis case report in Rio de Janeiro, Brazil, and literature review. Mycopathologia 181(9–10), 701–708 (2016).
- 3. Paracoccidioidomycosis after highway construction, Rio de Janeiro, Brazil. Emerg. Infect. Dis. 23(11), 1917–1919 (2017). • This report describes an outbreak of paracoccidioidomycosis after highway construction.
- 4. Brazilian guidelines for the clinical management of paracoccidioidomycosis. Rev. Soc. Bras. Med. Trop. 50(5), 715–740 (2017). •• Brazilian guidelines for paracoccidioidomycosis.
- 5. Sporotrichosis: an emerging neglected opportunistic infection in HIV-infected patients in Rio de Janeiro, Brazil. PLoS Negl. Trop. Dis. 8(8), e3110 (2014). • This retrospective study demonstrated a cohort of sporotrichosis and HIV infection from a national reference institute.
- 6. Sporotrichosis in Rio de Janeiro, Brazil: sporothrix brasiliensis is associated with atypical clinical presentations. PLoS Negl. Trop. Dis. 8(9), e3094 (2014).
- 7. Bone sporotrichosis: 41 cases from a reference hospital in Rio de Janeiro, Brazil. PLoS Negl. Trop. Dis. 15(3), e0009250 (2021).
- 8. Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management. An. Bras. Dermatol. 97(6), 757–777 (2022). •• This study provides recommendations for the clinical management of sporotrichosis in Brazil.
- 9. Cryosurgery for the treatment of cutaneous sporotrichosis in four pregnant women. PLoS Negl. Trop. Dis. 12(4), e0006434 (2018). • This case series explores cryosurgery as an alternative treatment for sporotrichosis in pregnant women.
- 10. Electrosurgery as adjuvant therapy for cutaneous sporotrichosis. Dermatol. Surg. 46(1), 140–142 (2020). • This case series presents electrosurgery as an adjuvant therapy for sporotrichosis.
- 11. A combination of photodynamic therapy and antimicrobial compounds to treat skin and mucosal infections: a systematic review. Photochem. Photobiol. Sci. 18(5), 1020–1029 (2019).
- 12. . Dyes, flies, and sunny skies: photodynamic therapy and neglected tropical diseases. Color Technol. 133(1), 3–14 (2017).
- 13. . Antimicrobial efficacy of photodynamic therapy on the treatment of oral candidiasis in people living with HIV/Aids. Rev. Fun. Care Online 12, 509–512 (2020).
- 14. Cutaneous sporotrichosis treated with methylene blue-daylight photodynamic therapy. J. Eur. Acad. Dermatol. Venereol. 32(3), e90–91 (2018).
- 15. Photodynamic therapy in the treatment of oral lesions caused by paracoccidiomycosis. Photodiagnosis Photodyn. Ther. 37, 102648 (2022).
- 16. Photodynamic therapy efficiently controls dermatophytosis caused by Trichophyton rubrum in a murine model. Br. J. Dermatol. 172(3), 801–804 (2015).
- 17. Use of mycelial-phase Sporothrix schenckii exoantigens in an enzyme-linked immunosorbent assay for diagnosis of sporotrichosis by antibody detection. Clin. Vaccine Immunol. 14(3), 244–249 (2007).
- 18. . Diagnóstico laboratorial das micoses. In: Fundamentos das Doenças Infecciosas e Parasitárias. Coura JRPereira NG (Eds). Elsevier, Rio de Janeiro, Brazil, 394–401 (2019).
- 19. Screening paracoccidioidomycosis by double immunodiffusion test in a referred diagnostic center in Brazilian southeastern: an accessible tool. Infection 49(6), 1257–1264 (2021).
- 20. . Molecular diagnosis of pathogenic Sporothrix species. PLoS Negl. Trop. Dis. 9(12), e0004190 (2015).
- 21. . Combined antimicrobial activity of photodynamic inactivation and antimicrobials – state of the art. Front. Microbiol. 9, 930 (2018). •• This study presents the state of the art of antimicrobial photodynamic inactivation adjuvant to antimicrobials.