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Photodynamic Therapy Combined with Terbinafine Against Chromoblastomycosis and the Effect of PDT on Fonsecaea monophora In Vitro

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Abstract

Chromoblastomycosis, a chronic fungal infection of skin and subcutaneous tissue caused by dematiaceous fungi, is associated with low cure and high relapse rates. Among all factors affecting clinical outcome, etiological agents have an important position. In southern China, Fonsecaea pedrosoi and Fonsecaea monophora are main causative agents causing Chromoblastomycosis. We treated one case of chromoblastomycosis by photodynamic therapy (PDT) of 5-aminolevulinic acid (ALA) irradiation combined with terbinafine 250 mg a day. The lesions were improved after two sessions of ALA-PDT treatment, each including nine times, at an interval of 1 week, combined with terbinafine 250 mg/day oral, and clinical improvement could be observed. In the following study, based on the clinical treatment, the effect of PDT and antifungal drugs on this isolate was detected in vitro. It showed sensitivity to terbinafine, itraconazole or voriconazole, and PDT inhibited the growth. Both the clinic and experiments in vitro confirm the good outcome of ALA-PDT applied in the inhibition of F. monophora. It demonstrated that combination of antifungal drugs with ALA-PDT arises as a promising alternative method for the treatment of these refractory cases of chromoblastomycosis.

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Acknowledgments

This work was kindly supported by the National Natural Science Foundation of China (81371747).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Rd, Guangzhou, 510120, China

    Yongxuan Hu, Xiaowen Huang, Sha Lu, Junmin Zhang & Liyan Xi

  2. Department of Dermatology and Venerology, The Third Affiliated Hospital of Southern Medical University, 183 West Zhongshan Rd, Guangzhou, 510630, China

    Yongxuan Hu

  3. Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA

    Michael R. Hamblin

  4. Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA

    Michael R. Hamblin

  5. Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, 02139, USA

    Michael R. Hamblin

  6. Department of Medicine, Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02903, USA

    Eleftherios Mylonakis

Authors
  1. Yongxuan Hu
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  2. Xiaowen Huang
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  3. Sha Lu
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  4. Michael R. Hamblin
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  5. Eleftherios Mylonakis
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  6. Junmin Zhang
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  7. Liyan Xi
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Corresponding author

Correspondence to Liyan Xi.

Additional information

Yongxuan Hu and Xiaowen Huang contributed equally to this work.

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Hu, Y., Huang, X., Lu, S. et al. Photodynamic Therapy Combined with Terbinafine Against Chromoblastomycosis and the Effect of PDT on Fonsecaea monophora In Vitro. Mycopathologia 179, 103–109 (2015). https://doi.org/10.1007/s11046-014-9828-3

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  • DOI: https://doi.org/10.1007/s11046-014-9828-3

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