Alberdi Enrique, Gómez Clara
Private Clinic of Dr. Alberdi, Madrid, Spain.
Institute of Physical Chemistry Rocasolano, CSIC, Madrid, Spain.
Photodermatol Photoimmunol Photomed. 2020 Jul;36(4):308-312. doi: 10.1111/phpp.12555. Epub 2020 Apr 6.
Although systemic therapies are recommended for severe or recalcitrant cases of pityriasis versicolor (PV), they are not free of important side effects and drug interactions. Photodynamic therapy (PDT) utilizes the action of singlet oxygen and free radicals produced by a light-activated photosensitizer to kill viruses, bacteria, or fungi. In this study, the effect of a PDT mediated by methylene blue (MB) in PV was evaluated.
Five women with PV disseminated on the back and diagnosed by fresh microscopic analysis were treated with a solution of MB (2%) applied to the PV lesions for 3 minutes. Next, a red LED lamp (λ = 630±5 nm, 37 J/cm ), placed 100 mm from the skin for 10 minutes, was applied on the dyed PV lesions. Six sessions of MB/PDT were implemented with a 2-week interval in between. Wood's lamp examination was used to monitor fungal infection at each time point.
Complete cure was observed in the five women at the 4 weeks post-treatment follow-up. Fluoresce images from PV lesions by Wood's lamp allowed to evaluate whether the lesions were healed or not at each time point. No patient showed relapse at the 6-month follow-up. The patients did not have any adverse effect, and good cosmetic outcome was observed.
Six sessions of MB/PDT spaced at 14-day intervals are sufficient for the treatment for PV in healthy patients.
尽管对于重度或顽固性花斑糠疹（PV）推荐采用全身治疗，但这些治疗并非没有重要的副作用和药物相互作用。光动力疗法（PDT）利用光激活的光敏剂产生的单线态氧和自由基的作用来杀死病毒、细菌或真菌。在本研究中，评估了亚甲蓝（MB）介导的光动力疗法对花斑糠疹的疗效。
对5名背部患有播散性花斑糠疹且经新鲜显微镜分析确诊的女性，将2%的MB溶液涂抹于花斑糠疹皮损上3分钟进行治疗。接下来，将红色发光二极管灯（λ = 630±5 nm，37 J/cm²）置于距皮肤100 mm处照射10分钟，照射于染色后的花斑糠疹皮损上。共进行6次MB/PDT治疗，每次间隔2周。每次均使用伍德灯检查监测真菌感染情况。
在治疗后4周的随访中，5名女性均实现了完全治愈。伍德灯拍摄的花斑糠疹皮损荧光图像可用于评估各时间点皮损是否愈合。在6个月的随访中，无患者复发。患者未出现任何不良反应，且美容效果良好。
间隔14天进行6次MB/PDT治疗足以治愈健康患者的花斑糠疹。
