Photodynamic therapy in the treatment of superficial mycoses: an evidence-based evaluation

Photodynamic therapy (PDT) is effective in the destruction of fungi. In order to evaluate the efficacy and safety of PDT for superficial mycoses, we performed an evidence-based review of published literature. Database of MEDLINE, EMBASE, and Cochrane Library was searched until March 2010. English-language articles evaluating the efficacy and safety of PDT for superficial mycoses were included. No randomized clinical trials were found. Seven reports described the antifungal effect of PDT against 63 superficial mycoses patients. Eight of 10 (80%) tinea cruris patients and 6 of 10 (60%) tinea pedis were led to mycological cure after 1-3 treatments. Unfortunately, only 4 (40%) tinea cruris patients and 3 (30%) tinea pedis had a persist healing at the 8-week follow-up. Six of the 9 (66.7%) foot-interdigital mycoses patients recovered clinically and microbiologically after 1 or 4 treatments. Only 2 patients (22.2%) had a persist healing at the 8-week follow-up. Eleven of 30 (36.6%) onychomycosis patients were cure for 18 months after treatment, and 3 onychomycosis patients were all cure in other 2 reports. The therapeutic effect of PDT for one pityriasis versicolor patients was well. Overall tolerability of PDT was good. Therefore, it is unclear what PDT's place for superficial mycoses will be. Further clinical trials are needed to evaluate the efficacy of PDT to treat superficial mycoses. It is also important to optimize treatment protocols in order to cope with recurrence.