Raffaele Regina Maria, Baldo Mario Eduardo, Santana Gabriel Umbelino, Siqueira Juliana Mota, Palma Luiz Felipe, Campos Luana
Dentistry Service of Charity Hospital of Campo Grande. Campo Grande, MS, Brazil; Study Group of Laser and Health Institute. São Paulo, SP, Brazil.
Dentistry Service of Charity Hospital of Campo Grande. Campo Grande, MS, Brazil; Graduate Program on Health and Development in West Central Region, Federal University of Mato Grosso do Sul. Campo Grande, MS, Brazil.
Photodiagnosis Photodyn Ther. 2022 Dec;40:103094. doi: 10.1016/j.pdpdt.2022.103094. Epub 2022 Aug 28.
Erythema multiforme (EM) is a reactive mucocutaneous disorder typically initiated by viral infections. Although the management of EM differs according to the clinical course and trigger factor, it is not clear whether antiviral suppressive therapies may be useful in cases related to such infections. Moreover, the treatment is most often based on supportive care directed towards only the symptoms.
To present a clinical case of a child in which antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) were used for orofacial manifestations of EM secondary to viral infections.
A Brazilian 1-year-old boy was admitted to an ICU due to a severe Influenza A H3N2 infection, pneumonia with pleural effusion, and sepsis. About 10 days later, it was noted bleeding lip lesions covered by crusts and bleeding tongue lesions, diagnosed as EM secondary to both H3N2 and herpes simplex virus infections, confirmed by serology tests. A combination of an aPDT session and six PBMT sessions was proposed and resulted in almost complete resolution of the lesion on the 7th day.
Given the complexity of the present case, the combination of phototherapies seems to be a promising tool for treating acute orofacial mucosal lesions of viruses-induced EM. More studies, however, are needed to reach a definite conclusion.
多形红斑（EM）是一种反应性皮肤黏膜疾病，通常由病毒感染引发。尽管EM的治疗方法会根据临床病程和触发因素而有所不同，但对于与此类感染相关的病例，抗病毒抑制疗法是否有用尚不清楚。此外，治疗通常大多仅基于针对症状的支持性护理。
介绍一例使用抗菌光动力疗法（aPDT）和光生物调节疗法（PBMT）治疗继发于病毒感染的EM口腔面部表现的儿童临床病例。
一名1岁巴西男孩因严重的甲型H3N2流感感染、伴有胸腔积液的肺炎和败血症入住重症监护病房。大约10天后，发现其嘴唇有结痂覆盖的出血性病变，舌头有出血性病变，经血清学检测确诊为继发于H3N2和单纯疱疹病毒感染的EM。采用一次aPDT治疗和六次PBMT治疗相结合的方法，在第7天时病变几乎完全消退。
鉴于本病例的复杂性，光疗法的联合应用似乎是治疗病毒诱导的EM急性口腔面部黏膜病变的一种有前景的工具。然而，需要更多研究才能得出明确结论。
