Phototherapies for the management of a large painful facial cutaneous lesion from human monkeypox infection.

BACKGROUND

The management of patients with Monkeypox (MPX) infection is generally symptomatic as there has been no approved antiviral drug so far. Despite being generally a self-limited disease, some complications may be encountered such as severe pain and the formation of permanent skin scarring.

AIM: To present a case report in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for a large facial cutaneous lesion in an MPX patient.

CASE REPORT: A 20-year-old Caucasian man presenting with a large, painful, grayish, rubbery, well-circumscribed, deep-seated, and umbilicated ulcer on his face was treated with four daily sessions of PBMT and two sessions of aPDT every other day. Within a day, the patient's pain complaint was no longer present and a crust central area was visible. On the 4th day of laser treatment, the wound almost completely disappeared, leaving a small reddish area free of inflammation or infection signs and without unaesthetic skin scarring.

CONCLUSION

Given the lack of specific strategies for the management of severe MPX-related skin lesions, the current case report suggests that the concomitant use of PMBT and aPDT seems to be a promising therapeutic approach. The most appropriate laser parameters, however, should be further investigated in future studies in order to establish an effective and reliable clinical protocol.