Photodynamic therapy in comprehensive treatment of resistant forms of dermatomycosis caused by Trichophyton indotineae

Background. There has been an alarming trend of Trichophyton indotineae anthropophilic dermatophyte spread beyond its original area in India in recent years. This pathogen is actively penetrating new territories including countries in Europe and the Middle East. The reported cases of cutaneous mycosis in patients in the Russian Federation are of particular concern, indicating that the pathogen has penetrated into our country. T. indotineae is a serious problem for public health because they are highly contagious fungi, resistant to standard treatment methods, cause skin mycoses with extensive areas of lesions and are accompanied by an intense itching that significantly reduces the quality of life of patients. Material and methods. A comprehensive approach, including microscopic study, mycologic seeding and molecular-biological (-genetic) methods, was used for precise identification of the pathogen. This made it possible not only to identify the pathogen’s presence, but also to determine its species membership. As part of the therapeutic strategy, an innovative method of photodynamic therapy using a chlorine-containing photosensitizer was applied, that expanded the treatment options for resistant forms of dermatomycosis. Results. The article describes 2 cases of intra-familial infection with T. indotineae. Fungal skin lesion was not susceptible to standard treatment in both cases. A combined approach involving systemic antifungal drugs, topical treatment and photodynamic therapy with a chlorine-containing photosensitizer was applied. Conclusion. This study confirms that to effectively combat the growing threat of persistent dermatophyte infections requires a comprehensive approach, including improvement of diagnosis, namely the implementation of molecular screening methods and development of new treatment techniques.