Cutaneous Sporotrichosis Treated with Photodynamic Therapy: An in Vitro and in Vivo Study

BACKGROUND: Sporotrichosis is a fungal infection caused by Sporothrix schenckii complex, usually restricted to the skin, subcutaneous cellular tissue, and adjacent lymphatic vessels. Antimicrobial photodynamic therapy (aPDT) could be a good alternative to manage localized, superficial infections. CASE REPORT: A 65-year-old African woman was diagnosed with a fixed cutaneous sporotrichosis on her left arm, treated with itraconazol and oral terbinafine with partial improvement. Topical 16% methyl aminolevulinate (MAL, Metvix(®))-PDT was used without success. METHODS: An in vitro photoinactivation test with the isolated microorganism revealed phenothiazinium salts to be more effective than MAL. CONCLUSIONS: PDT with intralesional 1% methylene blue (MB) in combination with intermittent low doses of itraconazole obtained complete microbiological and clinical response.