A rare case of refractory facial phaeohyphomycosis caused by Cladosporium halotolerans successfully treated with aminolevulinic acid photodynamic therapy

Photodiagnosis Photodyn Ther. 2023 Jun:42:103347. doi: 10.1016/j.pdpdt.2023.103347. Epub 2023 Feb 16.

Abstract

A 55-year-old female presented with a gradually enlarged red plaque and ulceration on the right side of her nose, face and suborbital region for ten years. The histopathologic features indicated infectious granuloma. The results of the fungal culture of the tissue and DNA sequencing identified as Cladosporium halotolerans infection. The patient was diagnosed with phaeohyphomycosis due to Cladosporium halotolerans. In this case, it was unsuitable for surgical treatment since the lesion was located periorbital. Furthermore, the patient had a poor response to oral itraconazole (400 mg/d) for 9 months. Therefore, ALA-PDT was added to the treatment regimen. The patient received ALA-PDT irradiation 5 times at 2-week intervals and achieved significant clinical remission. We believe that ALA-PDT may be an effective and safe adjuvant therapy.

Keywords: ALA-PDT; Aminolevulinic acid; Cladosporium halotolerans; Itraconazole; Photodynamic therapy; Photosensitizing agents.

Publication types

  • Case Reports

MeSH terms

  • Aminolevulinic Acid / therapeutic use
  • Cladosporium
  • Female
  • Humans
  • Middle Aged
  • Phaeohyphomycosis* / drug therapy
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use

Substances

  • Aminolevulinic Acid
  • Photosensitizing Agents

Supplementary concepts

  • Cladosporium halotolerans