Local thermotherapy to treat cutaneous sporotricosis
Update on the global accumulated experience
Keywords:
SPOROTRICHOSIS, INDICATED HYPERTHERMIAAbstract
Sporotricosis represents the most frequent human deep mycosis in Uruguay, and it is usually treated with oral potassium iodide. However, local hyperthermia is also frequently used successfully according to several international studies.
The present study aims at the following objectives: 1) to go over the first scientific research that proved the effect of environmental temperature on experimental sporotricosis in laboratory animals, and its immediate consequence on the successful application of local thermotherapy in a human case in Uruguay, back in 1962; 2)to review literature on subsequent clinical trials on local thermotherapy to treat human sporotricosis in other countries and the results obtained in the application of different therapeutic designs; 3) to analyse the main biological mechanisms of action for local thermotherapy in the process of healing lesions according to the results obtained in multiple research studies.
The main conclusion is the current universal acceptance of the effectiveness and harmlessness of local thermotherapy on the disease, whose main indications are iodine intolerance and special physiological situations, such as pregnancy, when they are contraindicated. Local heat is advisable as a complementary treatment to iodine when well tolerated or to itraconazole, with the purpose of shortening the period needed for curing.
According to research conducted by different authors until today, local heat therapy to cure sporotricosis would result from several biological mechanisms. Among them, the direct inhibition of Sporothrix schenckii parasite cells in tissues, localized Hyperleukocytosis, a greater and non-specific action of phagocytosis and other host defense mechanisms; last, a greater efficiency in intra-lekocyte death of parasites through an improved use of I stemming form the MPO- H2O2- I system.
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