{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:47:40Z","timestamp":1782712060459,"version":"3.54.5"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008532","name":"Universidade Federal Do Rio Grande Do Norte","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008532","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lasers Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This preliminary prospective study aimed to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct treatment for angular cheilitis (AC) in critically ill patients and to investigate its feasibility in a high-complexity hospital setting. The study included 13 patients admitted to the intensive care unit (ICU) of a referral infectious disease hospital in Northeastern Brazil. The aPDT protocol consisted of 0.1% methylene blue (10-minute pre-irradiation) followed by low-level laser therapy (660\u00a0nm, 4\u00a0J\/point, 40\u00a0s) applied to three points per affected commissure. Clinical evolution was monitored at T1 (72\u00a0h), T2 (7 days), and T3 (follow-up), with lesions classified according to severity. Most patients presented severe systemic compromise, predominantly related to HIV infection and diabetes mellitus. In addition, 76.9% of patients exhibited concomitant oral candidiasis, and 92.3% were receiving systemic antifungal therapy. Complete lesion regression was observed in 40% of patients within 72\u00a0h (T1). By the final follow-up (T3), the overall clinical cure rate reached 61.5% (8\/13), including cases of delayed resolution confirmed up to day 15. Although a 30.8% loss to follow-up occurred due to the inherent challenges of the intensive care setting, no adverse effects or complications were reported. Within the limitations of this preliminary study, aPDT demonstrated promising clinical applicability as an adjunctive approach for managing angular cheilitis in critically ill patients.<\/jats:p>","DOI":"10.1007\/s10103-026-04931-3","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:38:14Z","timestamp":1782711494000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial photodynamic therapy for the treatment of angular cheilitis in critically Ill patients: a prospective study"],"prefix":"10.1007","volume":"41","author":[{"given":"Andr\u00e9 Luis Alves","family":"Borges","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Emmily Melo","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana Bernardo Farias","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssika Gulherme de Almeida","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9ricka Janine Dantas","family":"da Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"4931_CR1","doi-asserted-by":"publisher","unstructured":"Quintanilha RMC, Pereira MRR, Oliveira SP, Penoni DC, Salgado DR, Agostini M, Torres SR (2023) Oral clinical findings and intensive care unit prognostic scores. BMJ Support Palliat Care. https:\/\/doi.org\/10.1136\/spcare-2023-004479","DOI":"10.1136\/spcare-2023-004479"},{"issue":"5","key":"4931_CR2","doi-asserted-by":"publisher","first-page":"e280","DOI":"10.1016\/S1473-3099(24)00749-7","volume":"25","author":"OA Cornely","year":"2025","unstructured":"Cornely OA, Sprute R, Bassetti M, Chen SC, Groll AH, Kurzai O, Lass-Fl\u00f6rl C, Ostrosky-Zeichner L, Rautemaa-Richardson R, Revathi G, Santolaya ME, White PL, Alastruey-Izquierdo A, Arendrup MC, Baddley J, Barac A, Ben-Ami R, Brink AJ, Grothe JH, Guinea J, Zhu LP (2025) Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM. The Lancet. Infect Dis 25(5):e280\u2013e293. https:\/\/doi.org\/10.1016\/S1473-3099(24)00749-7","journal-title":"Infect Dis"},{"issue":"3","key":"4931_CR3","doi-asserted-by":"publisher","first-page":"116687","DOI":"10.1016\/j.diagmicrobio.2025.116687","volume":"111","author":"PHdaC Ferreira","year":"2025","unstructured":"Ferreira PHdaC, Moura CRF, Lage VKdaS, Teixeira LAdaC, Costa HS, Figueiredo PHS\u2026 Mendon\u00e7a, V. A. (2025) Factors associated with the presence of Candida spp. in the oral and tracheobronchial secretions of patients admitted to an adult intensive care unit. Diagn Microbiol Infect Dis 111(3):116687. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2025.116687","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"6","key":"4931_CR4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3892\/mi.2025.278","volume":"5","author":"W Ghaly Elmasry","year":"2025","unstructured":"Ghaly Elmasry W, Abdelbaky M, A., Ahmed Awad AH (2025) Management of invasive candidiasis in the ICU: Challenges and advances (Review). Med Int 5(6):79. https:\/\/doi.org\/10.3892\/mi.2025.278","journal-title":"Med Int"},{"issue":"105228","key":"4931_CR5","doi-asserted-by":"publisher","first-page":"105228","DOI":"10.1016\/j.pdpdt.2025.105228","volume":"56","author":"C Casu","year":"2025","unstructured":"Casu C, Natoli V, Inchingolo AM, Orr\u00f9 G (2025) Refractory angular cheilitis treated with photodynamic therapy (PDT): an observational pilot study. Photodiagn Photodyn Ther 56(105228):105228. https:\/\/doi.org\/10.1016\/j.pdpdt.2025.105228","journal-title":"Photodiagn Photodyn Ther"},{"key":"4931_CR6","doi-asserted-by":"publisher","unstructured":"Chiriac A, Chiriac EA, Pinteala T, Spinei A, Savin L, Zelenkova H, Wollina U (2024) Angular cheilitis-an oral disease with many facets. Wien Med Wochenschr 174(15\u201316):315\u2013322. https:\/\/doi.org\/10.1007\/s10354-024-01037-9","DOI":"10.1007\/s10354-024-01037-9"},{"key":"4931_CR7","doi-asserted-by":"publisher","unstructured":"Adnan RO, Jawad HA (2024) Antimicrobial photodynamic therapy using a low-power 650 nm laser to inhibit oral Candida albicans activity: an in vitro study. J Med Life 17(1):28\u201334. https:\/\/doi.org\/10.25122\/jml-2023-0285","DOI":"10.25122\/jml-2023-0285"},{"key":"4931_CR8","doi-asserted-by":"publisher","unstructured":"Silva LBBda, Castilho IG, Souza Silva FAde, Ghannoum M, Garcia MT, Carmo PHFdo (2025) Antimicrobial photodynamic therapy for superficial, skin, and mucosal fungal infections: An update. Microorganisms 13(6):1406. https:\/\/doi.org\/10.3390\/microorganisms13061406","DOI":"10.3390\/microorganisms13061406"},{"issue":"7","key":"4931_CR9","doi-asserted-by":"publisher","first-page":"555","DOI":"10.3390\/jof7070555","volume":"7","author":"S-Y Lu","year":"2021","unstructured":"Lu S-Y (2021) Oral candidosis: Pathophysiology and best practice for diagnosis, classification, and successful management. J Fungi (Basel Switzerland) 7(7):555. https:\/\/doi.org\/10.3390\/jof7070555","journal-title":"J Fungi (Basel Switzerland)"},{"issue":"1","key":"4931_CR10","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3390\/jof9010111","volume":"9","author":"LM Dias","year":"2023","unstructured":"Dias LM, Klein MI, Ferrisse TM, Medeiros KS, Jord\u00e3o CC, Bellini A, Pavarina AC (2023) The effect of sub-lethal successive applications of photodynamic therapy on Candida albicans biofilm depends on the photosensitizer. J Fungi (Basel Switzerland) 9(1):111. https:\/\/doi.org\/10.3390\/jof9010111","journal-title":"J Fungi (Basel Switzerland)"},{"issue":"3","key":"4931_CR11","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3390\/ph12030140","volume":"12","author":"KJR Hidalgo","year":"2019","unstructured":"Hidalgo KJR, Carmello JC, Carolina Jord\u00e3o C, Barbugli A, de Sousa Costa P, Mima CA, E. G., Pavarina AC (2019) Antimicrobial photodynamic therapy in combination with nystatin in the treatment of experimental oral candidiasis induced by Candida albicans resistant to fluconazole. Pharmaceuticals (Basel Switzerland) 12(3):140. https:\/\/doi.org\/10.3390\/ph12030140","journal-title":"Pharmaceuticals (Basel Switzerland)"},{"key":"4931_CR12","doi-asserted-by":"publisher","first-page":"102983","DOI":"10.1016\/j.pdpdt.2022.102983","volume":"39","author":"LL de Fonseca","year":"2022","unstructured":"Fonseca LL, Dur\u00e3es CP, Menezes AS, da S, Tabosa ATL, Barbosa CU, Filho A, de Guimar\u00e3es PS, A. L. S (2022) Comparison between two antimicrobial photodynamic therapy protocols for oral candidiasis in patients undergoing treatment for head and neck cancer: a two-arm, single-blind clinical trial. Photodiagn Photodyn Ther 39:102983. https:\/\/doi.org\/10.1016\/j.pdpdt.2022.102983","journal-title":"Photodiagn Photodyn Ther"},{"issue":"11","key":"4931_CR13","doi-asserted-by":"publisher","first-page":"6471","DOI":"10.1007\/s00784-023-05252-3","volume":"27","author":"MR de Souto Medeiros","year":"2023","unstructured":"de Souto Medeiros MR, da Silva Barros CC, de Macedo Andrade AC, de Lima KC, da Silveira \u00c9JD (2023) Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial. Clin Oral Invest 27(11):6471\u20136482. https:\/\/doi.org\/10.1007\/s00784-023-05252-3","journal-title":"Clin Oral Invest"},{"issue":"1","key":"4931_CR14","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1186\/s12903-023-03484-z","volume":"23","author":"Q Hu","year":"2023","unstructured":"Hu Q, Li T, Yang J, Peng Y, Liu Q, Liu N (2023) Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis. BMC Oral Health 23(1):802. https:\/\/doi.org\/10.1186\/s12903-023-03484-z","journal-title":"BMC Oral Health"},{"key":"4931_CR15","doi-asserted-by":"publisher","first-page":"104729","DOI":"10.1016\/j.pdpdt.2025.104729","volume":"54","author":"Y Lin","year":"2025","unstructured":"Lin Y, Ding J, He Y, Zhang M, Zhang J, Zhong H, Liu Q, He J (2025) Photodynamic therapy for oral candidiasis in human clinical trials: an evidence-based analysis. Photodiagn Photodyn Ther 54:104729. https:\/\/doi.org\/10.1016\/j.pdpdt.2025.104729","journal-title":"Photodiagn Photodyn Ther"},{"issue":"6","key":"4931_CR16","doi-asserted-by":"publisher","first-page":"661","DOI":"10.4103\/ijdr.IJDR_668_16","volume":"28","author":"N Oza","year":"2017","unstructured":"Oza N, Doshi JJ (2017) Angular cheilitis: a clinical and microbial study. Indian J Dent Research: Official Publication Indian Soc Dent Res 28(6):661\u2013665. https:\/\/doi.org\/10.4103\/ijdr.IJDR_668_16","journal-title":"Indian J Dent Research: Official Publication Indian Soc Dent Res"},{"issue":"1","key":"4931_CR17","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s12105-019-01004-6","volume":"13","author":"JW Hellstein","year":"2019","unstructured":"Hellstein JW, Marek CL (2019) Candidiasis: Red and white manifestations in the oral cavity. Head Neck Pathol 13(1):25\u201332. https:\/\/doi.org\/10.1007\/s12105-019-01004-6","journal-title":"Head Neck Pathol"},{"issue":"101810","key":"4931_CR18","doi-asserted-by":"publisher","first-page":"101810","DOI":"10.1016\/j.pdpdt.2020.101810","volume":"31","author":"V P\u00e9rez-Laguna","year":"2020","unstructured":"P\u00e9rez-Laguna V, Garc\u00eda-Luque I, Ballesta S, P\u00e9rez-Artiaga L, Lampaya-P\u00e9rez V, Rezusta A, Gilaberte Y (2020) Photodynamic therapy using methylene blue, combined or not with gentamicin, against Staphylococcus aureus and Pseudomonas aeruginosa. Photodiagn Photodyn Ther 31(101810):101810. https:\/\/doi.org\/10.1016\/j.pdpdt.2020.101810","journal-title":"Photodiagn Photodyn Ther"}],"container-title":["Lasers in Medical Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-026-04931-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10103-026-04931-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-026-04931-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:38:15Z","timestamp":1782711495000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10103-026-04931-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4931"],"URL":"https:\/\/doi.org\/10.1007\/s10103-026-04931-3","relation":{},"ISSN":["1435-604X"],"issn-type":[{"value":"1435-604X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"30 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Review Committee of the institution Approval No. 7.896.537.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from all patients or their legal guardians. When patients were unable to provide consent, it was obtained from their legal guardians. Specific consent for publication of clinical data was also obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"In the course of preparing this manuscript, the authors employed ChatGPT (OpenAI, GPT-5.5 version) to assist in reviewing the English language and condensing the content. Following the use of this tool, the authors thoroughly reviewed and revised the material as necessary, and we assume full responsibility for the final content of the publication.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Generative AI And AI-assisted technologies in the manuscript preparation process"}}],"article-number":"135"}}