Photodynamic antifungal therapy against chromoblastomycosis

Photodynamic therapy (PDT) is a minimally invasive approach, in which a photosensitizer compound is activated by exposure to light. The activation of the sensitizer drug results in several chemical reactions, such as the production of reactive oxygen species and other reactive molecules, which presence in the biological site leads to the damage of target cells. Although PDT has been primarily developed to combat cancerous lesions, this therapy can be employed for the treatment of several conditions, including infectious diseases. A wide range of microorganisms, including Gram-positive and Gram-negative bacteria, viruses, protozoa, and fungi, have demonstrated susceptibility to antimicrobial PDT. This treatment might consist in an alternative for the management of fungal infections. Antifungal photodynamic therapy has been successfully employed against Candida species, dermatophytes, and Aspergillus niger. Chromoblastomycosis is an infection that involves skin and subcutaneous tissues caused by the traumatic inoculation of dematiaceous fungi species, being that the most prevalent are Fonsecaea pedrosoi and Claphialophora carrionii. In the present work, the clinical applications of PDT for the treatment of chromoblastomycosis are evaluated. We have employed methylene blue as photosensitizer and a LED (Light Emitting Diode) device as light source. The results of this treatment are positive, denoting the efficacy of PDT against chromoblastomycosis. Considering that great part of the published works are focused on in vitro trials, these clinical tests can be considered a relevant source of information about antifungal PDT, since its results have demonstrated to be promising. The perspectives of this kind of treatment are analyzed in agreement with the recent literature involving antifungal PDT.