Aspiroz Carmen, Fortuño Cebamanos Blanca, Rezusta Antonio, Paz-Cristóbal Pablo, Domínguez-Luzón Fernando, Gené Díaz Josepa, Gilaberte Yolanda
Unidad de Microbiología, Hospital Royo Villanova, Zaragoza, España.
Rev Iberoam Micol. 2011 Oct-Dec;28(4):191-3. doi: 10.1016/j.riam.2011.03.004. Epub 2011 Apr 5.
Onychomycosis is one of the most prevalent fungal infections in the population with a higher rate of treatment failures. Photodynamic therapy (PDT) is based on the use of photosensitizers with light of an accurate wavelength, and in the presence of oxygen, reactive oxygen species are produced which induce cell death. PDT is widely used to treat non-melanoma skin cancer, and other indications are being investigated, especially in superficial infections.
To determine the effectiveness of PDT in a case of onychomycosis caused by moulds.
A 75-year-old woman was diagnosed with onychomycosis caused by Acremonium sclerotigenum in the 5th finger. She was treated with 3 sessions of PDT with methyl-aminolevulinate (MAL) separated by 15 days.
The patient achieved mycological and clinical cure and remains asymptomatic after 12 months of follow up.
This case illustrates the potential usefulness of MAL-PDT for onychomycosis. Its effectiveness, lack of adverse effects and satisfaction on the part of physicians and patients, suggest a promising future for this therapy in the management of superficial fungal infections, such as onychomycosis.
甲癣是人群中最常见的真菌感染之一，治疗失败率较高。光动力疗法（PDT）基于使用具有精确波长的光的光敏剂，在有氧气的情况下，会产生活性氧，从而诱导细胞死亡。PDT被广泛用于治疗非黑素瘤皮肤癌，其他适应症也在研究中，尤其是在浅表感染方面。
确定PDT治疗一例由霉菌引起的甲癣的有效性。
一名75岁女性被诊断为第5指由硬壳顶孢霉引起的甲癣。她接受了3次外用甲基氨基乙酰丙酸（MAL）的PDT治疗，每次治疗间隔15天。
患者实现了真菌学和临床治愈，随访12个月后仍无症状。
该病例说明了MAL-PDT治疗甲癣的潜在效用。其有效性、无不良反应以及医生和患者的满意度表明，这种疗法在治疗浅表真菌感染（如甲癣）方面有着广阔的前景。
