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Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis.
Lasers Surg Med. 2010 Feb; 42(2):192-6.LS

Abstract

BACKGROUND

Malassezia folliculitis commonly has been treated with oral antifungal medications. However, it has many therapeutic weaknesses such as infection relapse, drug resistance, or adverse effects like hepatotoxicity and gastrointestinal discomfort. Hence, there remains an ongoing need for alternative treatments for recalcitrant Malassezia folliculitis. Recently, many dermatologists suggest photodynamic therapy (PDT) as an alternative therapeutic option for its antimicrobial effect.

OBJECTIVE

To investigate the efficacy of methyl 5-aminolevulinic acid (MAL)-PDT for the treatment of recalcitrant Malassezia folliculitis.

MATERIALS AND METHODS

Six Korean patients aged 23-47 years with recalcitrant Malassezia folliculitis were enrolled in this study. The patients enrolled in this study either refused oral medication or were unable to take oral antifungal agents due to hepatotoxicity concerns. Thus, we offered these patients MAL-PDT as an alternative treatment option. For all patients, photographs of the lesion(s) were taken prior to initiating treatment. MAL cream (Metvix, Galderma, France) was applied to each lesion (located on the patients' trunks) and covered with an adhesive occlusive dressing polyurethane film (Tegaderm, 3M Healthcare, St. Paul, MN). After 3 hours, the cream was wiped off and illumination was performed immediately thereafter with non-coherent red light using light-emitting diodes (Aktilite lamp, PhotoCure, Oslo, Norway, average wavelength 630 nm, light dose 37 J/cm(2)). Illumination was performed for 7.5 minutes. Patients underwent totally three sessions of MAL-PDT at 2-week intervals. One month after the last PDT treatment, patients returned to the hospital and lesions were photographed.

RESULTS

After three sessions of MAL-PDT, inflammatory lesions had decreased and improved obviously in four patients, had improved slightly in one patient, and had not improved in one patient.

CONCLUSION

MAL-PDT may be an effective treatment option for patients with recalcitrant Malassezia folliculitis. However, the data on MAL-PDT are still limited, and additional controlled trials including multiple patients will be necessary to verify the results of this pilot study.

Authors+Show Affiliations

Department of Dermatology, Chung-Ang University College of Medicine, Seoul 140-757, South Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20166153

Citation

Lee, Jin Woong, et al. "Photodynamic Therapy: New Treatment for Recalcitrant Malassezia Folliculitis." Lasers in Surgery and Medicine, vol. 42, no. 2, 2010, pp. 192-6.
Lee JW, Kim BJ, Kim MN. Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis. Lasers Surg Med. 2010;42(2):192-6.
Lee, J. W., Kim, B. J., & Kim, M. N. (2010). Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis. Lasers in Surgery and Medicine, 42(2), 192-6. https://doi.org/10.1002/lsm.20857
Lee JW, Kim BJ, Kim MN. Photodynamic Therapy: New Treatment for Recalcitrant Malassezia Folliculitis. Lasers Surg Med. 2010;42(2):192-6. PubMed PMID: 20166153.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis. AU - Lee,Jin Woong, AU - Kim,Beom Joon, AU - Kim,Myeung Nam, PY - 2010/2/19/entrez PY - 2010/2/19/pubmed PY - 2010/5/21/medline SP - 192 EP - 6 JF - Lasers in surgery and medicine JO - Lasers Surg Med VL - 42 IS - 2 N2 - BACKGROUND: Malassezia folliculitis commonly has been treated with oral antifungal medications. However, it has many therapeutic weaknesses such as infection relapse, drug resistance, or adverse effects like hepatotoxicity and gastrointestinal discomfort. Hence, there remains an ongoing need for alternative treatments for recalcitrant Malassezia folliculitis. Recently, many dermatologists suggest photodynamic therapy (PDT) as an alternative therapeutic option for its antimicrobial effect. OBJECTIVE: To investigate the efficacy of methyl 5-aminolevulinic acid (MAL)-PDT for the treatment of recalcitrant Malassezia folliculitis. MATERIALS AND METHODS: Six Korean patients aged 23-47 years with recalcitrant Malassezia folliculitis were enrolled in this study. The patients enrolled in this study either refused oral medication or were unable to take oral antifungal agents due to hepatotoxicity concerns. Thus, we offered these patients MAL-PDT as an alternative treatment option. For all patients, photographs of the lesion(s) were taken prior to initiating treatment. MAL cream (Metvix, Galderma, France) was applied to each lesion (located on the patients' trunks) and covered with an adhesive occlusive dressing polyurethane film (Tegaderm, 3M Healthcare, St. Paul, MN). After 3 hours, the cream was wiped off and illumination was performed immediately thereafter with non-coherent red light using light-emitting diodes (Aktilite lamp, PhotoCure, Oslo, Norway, average wavelength 630 nm, light dose 37 J/cm(2)). Illumination was performed for 7.5 minutes. Patients underwent totally three sessions of MAL-PDT at 2-week intervals. One month after the last PDT treatment, patients returned to the hospital and lesions were photographed. RESULTS: After three sessions of MAL-PDT, inflammatory lesions had decreased and improved obviously in four patients, had improved slightly in one patient, and had not improved in one patient. CONCLUSION: MAL-PDT may be an effective treatment option for patients with recalcitrant Malassezia folliculitis. However, the data on MAL-PDT are still limited, and additional controlled trials including multiple patients will be necessary to verify the results of this pilot study. SN - 1096-9101 UR - https://www.unboundmedicine.com/medline/citation/20166153/Photodynamic_therapy:_new_treatment_for_recalcitrant_Malassezia_folliculitis_ L2 - https://doi.org/10.1002/lsm.20857 DB - PRIME DP - Unbound Medicine ER -