Owing to the accessibility of skin to light, many applications of photodynamic treatment (
PDT) have been developed within dermatology. The recent increase of dermatological antimicrobial
PDT investigations is related to the growing problem of bacterial and fungal resistance to
antibiotics. This review focuses on the susceptibility of dermatophytic fungi, in particular Trichophyton rubrum, to
PDT and shows its potential usefulness in treatment of clinical
dermatophytoses. There are no data indicating significant differences in
PDT susceptibility between various dermatophytes and it is unlikely that treatment problems of especially T. rubrum with current antimycotics would occur in case of
PDT. Red light 5-aminolevulinic
acid-mediated
PDT is after repeated sessions successful in in vivo treatment of
onychomycosis (fungal nail
infection) caused by various dermatophytes. Regarding skin
dermatophytoses, UVA-1
PDT with cationic
porphyrins appears to be safe and efficient. Most effective toward T. rubrum ex vivo is 5,10,15-tris(4-methylpyridinium)-20-phenyl-[21H,23H]-
porphine trichloride (
Sylsens B) when combined with UVA-1 radiation or red light; this creates the possibility of efficiently treating nail
infections and remaining spores in hair follicles. If the promising in vitro and ex vivo results could be transferred to clinical practice, then
PDT has a good prospect to become a worthy alternative to established antifungal drugs.