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

Photodiagnosis Photodyn Ther. 2020 Dec:32:101997. doi: 10.1016/j.pdpdt.2020.101997. Epub 2020 Sep 19.

Abstract

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.

Keywords: Antimicrobial photodynamic therapy; Breast cancer; Neutropenic ulcer; Oncological patients; Photobiomodulation.

Publication types

  • Case Reports

MeSH terms

  • Bacterial Infections* / drug therapy
  • Breast Neoplasms* / complications
  • Breast Neoplasms* / drug therapy
  • Female
  • Humans
  • Middle Aged
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Ulcer / drug therapy

Substances

  • Photosensitizing Agents