Local management of neutropenic ulcer in a patient under breast cancer treatment

•Antimicrobial Photodynamic therapy (aPDT) on management of neutropenic ulcer in a patient under breast cancer treatment.•Evidence for reducing local infection.•aPDT could be a safe and effective protocol on management of neutropenic ulcers. Neutropenic ulcers are characterized by regular margins wi...

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Bibliographic Details
Published in:	Photodiagnosis and photodynamic therapy Vol. 32; p. 101997
Main Authors:	Cotomacio, Claudia C., Magliano, Gabriela C., Alves, Fabio A., Simões, Alyne
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-12-2020
Subjects:	Antimicrobial photodynamic therapy Bacterial Infections - drug therapy Breast cancer Breast Neoplasms - complications Breast Neoplasms - drug therapy Female Humans Middle Aged Neutropenic ulcer Oncological patients Photobiomodulation Photochemotherapy - methods Photosensitizing Agents - therapeutic use Ulcer - drug therapy Breast cancer Oncological patients Antimicrobial photodynamic therapy Photobiomodulation Neutropenic ulcer
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Summary:	•Antimicrobial Photodynamic therapy (aPDT) on management of neutropenic ulcer in a patient under breast cancer treatment.•Evidence for reducing local infection.•aPDT could be a safe and effective protocol on management of neutropenic ulcers. Neutropenic ulcers are characterized by regular margins with a yellowish membrane, and are usually associated with severe pain and signs of inflammation due to opportunistic infections. Considering the immunosuppressed condition of these patients, local management of these lesions is a challenge. Antimicrobial photodynamic therapy (aPDT) is the association of light, which can be a low-power laser, with a photosensitizing agent and oxygen, whose synergy produces reactive oxygen species capable of reducing non-specific microbial contamination without causing side effects. The aim of this paper is to report a case of oral neutropenic ulcer treated with aPDT. A 50-year-old diabetic woman undergoing breast cancer treatment, presented with a malodorous malodorous and painful ulcer, which limited her basic oral functions. It was located in the maxillary alveolar ridge in the left first upper molar region and did not present bone involvement. Blood tests showed grade 2 of neutropenia. Thus, conservative treatment with aPDT technique was proposed. After one week, the lesion showed an improvement and pain had halved. The region was totally healed after three weeks. Local and non-invasive management of these lesions is of utmost importance for immunosuppressed patients, because it avoids systemic side effects and bacterial resistance resulting from overuse of antibiotics.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1572-1000 1873-1597
DOI:	10.1016/j.pdpdt.2020.101997