Efficacy of photodynamic therapy in cutaneous leishmaniasis: A systematic review

Daylight photodynamic therapy for cutaneous leishmaniasis in a pediatric setting: A case report and literature review

Cutaneous leishmaniasis (CL) is a vector-borne infection caused by the obligate intracellular parasites of the Leishmania genus. Children are more frequently affected due to increased exposure to sandflies and underdeveloped immune system. Currently, there is a lack of consensus on the most effective treatment approach for CL since most drugs are accompanied by numerous limitations, including adverse effects, toxicity, and onset of antimicrobial resistance phenomena. These limitations appear more relevant in the pediatric population, both for the treatment-related risks and for the reticence of the parents. Photodynamic therapy (PDT) has been increasingly employed in numerous inflammatory and infectious diseases, owing to its tissue selectivity and excellent cosmetic outcomes. On this topic, we report our experience with daylight-PDT (DL-PDT) therapy in a difficult-to-treat area like the facial region in a child with a six-month history of CL. Our case is paradigmatic of the potentiality of PDT to treat difficult lesions in a pediatric setting. However, its use has not yet been standardized either for the treatment of leishmania, with high variability in the number of sessions and time intervals. Specific protocols for pediatric patients should be better standardized in randomized clinical trials in order to provide clear indications for clinicians.

Adjunctive phototherapies for oral manifestation of HIV-related histoplasmosis and leishmaniasis: An unusual case report

BACKGROUND

Secondary infections of leishmaniasis and histoplasmosis in patients with advanced HIV are still a concern in low- and middle-income countries. The most common drugs for the treatment of both infections may be problematic mainly due to their toxicity.

AIM AND CASE REPORT

The present study aimed to report a case in which a concurrent oral manifestation of leishmaniasis and histoplasmosis in a hospitalized patient with HIV was managed with a combination of photobiomodulation therapy (PBMT) and antimicrobial photodynamic therapy (aPDT) as an adjuvant treatment. In addition to the use of conventional systemic oral drugs, a single aPDT session followed by two PBMT sessions was proposed, which resulted in complete wound healing within four days.

CONCLUSION

Given the complexity of the current case, PBMT in combination with aPDT may be considered as an effective adjuvant option for managing oral infectious lesions of histoplasmosis and leishmaniasis in immunocompromised patients.