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光疗治疗人感染猴痘后引起的大而疼痛的面部皮肤病变。

Phototherapies for the management of a large painful facial cutaneous lesion from human monkeypox infection.

机构信息

Dentistry Service, Charity Hospital of Campo Grande, Campo Grande, MS, Brazil.

Graduate Program in Health and Development in the Midwest Region, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.

出版信息

Photodiagnosis Photodyn Ther. 2023 Mar;41:103276. doi: 10.1016/j.pdpdt.2023.103276. Epub 2023 Jan 9.

Abstract

BACKGROUND

The management of patients with Monkeypox (MPX) infection is generally symptomatic as there has been no approved antiviral drug so far. Despite being generally a self-limited disease, some complications may be encountered such as severe pain and the formation of permanent skin scarring.

AIM

To present a case report in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for a large facial cutaneous lesion in an MPX patient.

CASE REPORT

A 20-year-old Caucasian man presenting with a large, painful, grayish, rubbery, well-circumscribed, deep-seated, and umbilicated ulcer on his face was treated with four daily sessions of PBMT and two sessions of aPDT every other day. Within a day, the patient's pain complaint was no longer present and a crust central area was visible. On the 4th day of laser treatment, the wound almost completely disappeared, leaving a small reddish area free of inflammation or infection signs and without unaesthetic skin scarring.

CONCLUSION

Given the lack of specific strategies for the management of severe MPX-related skin lesions, the current case report suggests that the concomitant use of PMBT and aPDT seems to be a promising therapeutic approach. The most appropriate laser parameters, however, should be further investigated in future studies in order to establish an effective and reliable clinical protocol.

摘要

背景

由于目前尚无批准的抗病毒药物,猴痘(MPX)感染患者的治疗通常为对症治疗。尽管该病通常为自限性疾病,但仍可能出现一些并发症,如严重疼痛和永久性皮肤瘢痕形成。

目的

报告 1 例采用抗菌光动力疗法(aPDT)和光生物调节疗法(PBMT)联合治疗 MPX 患者面部大皮损的病例。

病例报告

1 名 20 岁白人男性,面部出现 1 个大而疼痛的、灰色、橡胶样、边界清楚、深在且脐状的溃疡。患者接受了 4 天的 PBMT 和 2 天的 aPDT 治疗,每天治疗 1 次。治疗 1 天后,患者疼痛明显缓解,中央可见结痂。激光治疗第 4 天,创面几乎完全消失,仅遗留 1 个小红斑,无炎症或感染迹象,且皮肤瘢痕无明显不美观。

结论

鉴于目前缺乏针对严重 MPX 相关皮肤损伤的特定管理策略,本病例报告提示,PMBT 和 aPDT 的联合应用似乎是一种很有前途的治疗方法。然而,为了建立有效的、可靠的临床方案,还需要进一步研究最合适的激光参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c54/9827753/20824f591012/gr1_lrg.jpg

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