Advertisement

Mycopathologia

, Volume 183, Issue 5, pp 829–834 | Cite as

Successful Sequential Treatment with Itraconazole and ALA-PDT for Cutaneous Granuloma by Candida albicans: A Case Report and Literature Review

  • Qing Cai
  • Lian-juan Yang
  • Jia Chen
  • Hong Yang
  • Zhi-qin Gao
  • Xiu-li Wang
Original Paper

Abstract

Photodynamic therapy (PDT) is a process that combines a photosensitizing drug and light and promotes phototoxic responses in target cells, mainly via oxidative damage. Antifungal photodynamic therapy has been successfully employed against Candida species, dermatophytes, and deep mycoses. We present a case of a cutaneous granuloma caused by C. albicans treated with 5-aminolevulinic acid (ALA)-PDT. A 64-year-old man presented with two plaques on his right hand and wrist for 2 years. The diagnosis was made based on histopathology, mycology, and molecular identification of paraffin-embedded tissues. The patient was treated with itraconazole for 1 month and two sessions of ALA-PDT. After 2 months of follow-up, the patient was cured and has not experienced any recurrence to date. ALA-PDT was well tolerated in this patient with little pain. In general, application of PDT in mycoses is safe and effective in most cases. ALA-PDT is a good choice for inactivation of C. albicans.

Keywords

ALA-PDT Candida albicans Infectious granuloma 

Notes

Acknowledgements

We would like to thank our colleagues from the Institute of Photomedicine located in our hospital.

Funding

This work was supported by the National Natural Science Foundation of China (Grant Number 81573063) (General program), the National Natural Science Foundation of China (Grant Number 81602770) (Youth program), and the Project of Shanghai Municipal Commission of Health and Family Planning (Grant Numbers 20140388, 20164Y0248).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Cai Q, Lv GX, Jiang YQ, et al. The first case of phaeohyphomycosis caused by Rhinocladiella basitona in an immunocompetent child in China. Mycopathologia. 2013;176:101–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Ahmad S, Khan Z, Asadzadeh M, Theyyathel A, Chandy R. Performance comparison of phenotypic and molecular methods for detection and differentiation of Candida albicans and Candida dubliniensis. BMC Infect Dis. 2012;12:230.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Buchanan PJ, Mast BA, Lottenberg L, Kim T, Efron PA, Ang DN. Candida albicans necrotizing soft tissue infection: a case report and literature review of fungal necrotizing soft tissue infections. Ann Plast Surg. 2013;70:739–41.CrossRefPubMedGoogle Scholar
  4. 4.
    Kakeya H, Izumikawa K, Yamada K, Narita Y, Nishino T, Obata Y, et al. Concurrent subcutaneous candidal abscesses and pulmonary cryptococcosis in a patient with diabetes mellitus and a history of corticosteroid therapy. Intern Med. 2014;53:1385–90.CrossRefPubMedGoogle Scholar
  5. 5.
    Tuon FF, Nicodemo AC. Candida albicans skin abscess. Rev Inst Med Trop Sao Paulo. 2006;48:301–2.CrossRefPubMedGoogle Scholar
  6. 6.
    Yeh YW, Wang WM, Chiang CP, Wu BY, Liu PY, Chen YF. Invasive candidiasis presenting with multiple subcutaneous nodules mimicking sporotrichosis. Eur J Dermatol. 2010;20:535–6.PubMedGoogle Scholar
  7. 7.
    Kim M, Jung HY, Park HJ. Topical PDT in the treatment of benign skin diseases: principles and new applications. Int J Mol Sci. 2015;16:23259–78.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Calzavara-Pinton PG, Venturini M, Capezzera R, Sala R, Zane C. Photodynamic therapy of interdigital mycoses of the feet with topical application of 5-aminolevulinic acid. Photodermatol Photoimmunol Photomed. 2004;20:144–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Sotiriou E, Koussidou-Eremonti T, Chaidemenos G, Apalla Z, Ioannides D. Photodynamic therapy for distal and lateral subungual toenail onychomycosis caused by Trichophyton rubrum: preliminary results of a single-centre open trial. Acta Derm Venereol. 2010;90:216–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Piraccini BM, Rech G, Tosti A. Photodynamic therapy of onychomycosis caused by Trichophyton rubrum. J Am Acad Dermatol. 2008;59:S75–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Gilaberte Y, Aspiroz C, Martes MP, Alcalde V, Espinel-Ingroff A, Rezusta A. Treatment of refractory fingernail onychomycosis caused by nondermatophyte molds with methylaminolevulinate photodynamic therapy. J Am Acad Dermatol. 2011;65:669–71.CrossRefPubMedGoogle Scholar
  12. 12.
    Lee JW, Kim BJ, Kim MN. Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis. Lasers Surg Med. 2010;42:192–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Kim YJ, Kim YC. Successful treatment of pityriasis versicolor with 5-aminolevulinic acid photodynamic therapy. Arch Dermatol. 2007;143:1218–20.CrossRefPubMedGoogle Scholar
  14. 14.
    Lyon JP, e Silva Azevedo CDMP, Moreira LM, de Lima CJ, de Resende MA. Photodynamic antifungal therapy against chromoblastomycosis. Mycopathologia. 2011;172:293–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Gilaberte Y, Aspiroz C, Alejandre MC, Andres-Ciriano E, Fortuño B, Charlez L, et al. Cutaneous sporotrichosis treated with photodynamic therapy: an in vitro and in vivo study. Photomed Laser Surg. 2014;32:54–7.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Liu ZH, Xia XJ. Successful sequential treatment with itraconazole and ALA-PDT for chromoblastomycosis because of Alternaria alternata. Dermatol Ther. 2014;27:357–60.CrossRefPubMedGoogle Scholar
  17. 17.
    Munin E, Giroldo LM, Alves LP, Costa MS. Study of germ tube formation by Candida albicans after photodynamic antimicrobial chemotherapy (PACT). J Photochem Photobiol, B. 2007;88:16–20.CrossRefGoogle Scholar
  18. 18.
    Hosseini N, Yazdanpanah S, Saki M, Rezazadeh F, Ghapanchi J, Zomorodian K. Susceptibility of Candida albicans and Candida dubliniensis to photodynamic therapy using four dyes as the photosensitizer. J Dent. 2016;17:354–60.Google Scholar
  19. 19.
    Dai T, de Arce VJB, Tegos GP, Hamblin MR. Blue dye and red light, a dynamic combination for prophylaxis and treatment of cutaneous Candida albicans infections in mice. Antimicrob Agents Chemother. 2011;55:5710–7.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of MycologyShanghai Dermatology HospitalShanghaiChina
  2. 2.Department of PathologyShanghai Dermatology HospitalShanghaiChina
  3. 3.Institute of PhotomedicineShanghai Dermatology HospitalShanghaiChina

Personalised recommendations