Protoporphyrin IX Associated with Visible Light for the Treatment of Trichophyton rubrum Causing Onychomycosis - An Updated Review

Systemic medications used during the treatment of onychomycosis caused by Trichophyton rubrum may have relapse, making them costly and insignificant for the patient. Photodynamic therapy (PDT) is an advantageous therapeutic option for disease control, mainly due to the absence of risk of microbial resistance. The action of PDT is combined by three elements: photosensitizer (PS), visible light (VL) and molecular oxygen, leading to the formation of reactive oxygen species (ROS) or singlet oxygen formation (1O2), both ROS (type I mechanism) as 1O2 (type II mechanism) induce damage and death to microbial cells. This research was proposed as a study through a non-systematic review, to investigate the action of PS "Protoporphyrin IX" (Pp IX) associated with visible light on T. rubrum, contemplating clinical and relevant data regarding the treatment of onychomycosis by PDT. PubMed survey was conducted from June 2021 to April 2022. The research strategy included clinical trials, randomized trials, systematic reviews, meta-analyses and reviews in English. Pp IX has affinity for T. rubrum, which is justified by the incorporation of Pp IX into the cell membrane, which led to inhibition by LV irradiation. Thus, the photodynamic process of Pp IX may lead to cell death by type I and II mechanisms. The data found are promising, however, new studies in vitro and in vivo are suggested, since few studies have been found related to the theme