光動力療法對皮膚傷口感染之應用

Clinical application of photodynamic therapy for skin and soft tissue infection

現今許多慢性疾病如代謝性疾病像是糖尿病、心血管疾病、中風長期臥床， 在後期易影響皮膚的狀況造成免疫力下降，傷口癒合速度變慢，增加了細菌感染 的機率。然而因抗生素的濫用導致抗藥性細菌的產生，將使治療變得困難，而皮 膚又為人體第一道免疫防線，因此增加皮膚的防禦屏障與有效的治療變得更加重 要。世界衛生組織推出一項全球行動，如何透過較安全且有效的使用救命藥物， 阻止超級細菌的傳播。除了傳統藥物治療細菌感染外，近年來有文獻指出利用光 動力療法 （photodynamic therapy） 作為治療皮膚感染性或是慢性傷口以及腫瘤具 有良好的效果。近年有文獻回顧或是治療案例指出利用光動力治療 （結合光敏劑 藥物與可見光） 用來治療青春痘，對於不適合口服藥物治療的病人，是很好的輔 助治療。不但可以降低口服或是外用治療的副作用，另外對於減少抗藥性細菌的 產生，都是未來可以發展的皮膚治療方式，所以光動力治療應用在各種皮膚疾病 的治療上，是值得更深入的探討。（感控雜誌 2020:30:259-270）

Nowadays, many metabolic diseases in their later stage affect the skin and cause a decline in the immunity, resulting in slower wound healing and increasing the risk of bacterial infection. However, the emergence of drug-resistant bacteria (commonly known as "super bacteria") due to the abuse of antibiotics makes their treatment difficult. The skin is the first line of immunity for the body; therefore, it is important for treatment and defense against infections. The World Health Organization launched a national action in June this year, which will prevent these "super bacteria" by safe and effective use of life-saving drugs. The use of traditional drugs to treat bacterial infections have been reported; photodynamic therapy has shown a good effect in treating skin wounds and tumors. For example, in recent years, drugs have been used in the clinic (photoresponsive) combined with visible light to treat acne, and the need for oral medications not only cures but also reduces the burden on the body. Therefore, photodynamic therapy should be discussed in the treatment of drug-resistant bacteria in the treatment of skin.