Association between C. albicans and leukoplakia and its treatment with Photodynamic Therapy: a review of the literature and a case report

Objective: This paper deals with oral leukoplakia, a potential oral malignant disorder that often increases in malignancy due to an associated infection supported by the fungus Candida albicans. The work is aimed at describing this dual condition through a literature review and an unusual clinical case treated with Photodynamic Therapy. Materials and Methods: We used PubMed as a research engine in order to detect the most recent papers (2014-2023) written in English. Our main goal was to obtain more information about oral leukoplakia, its colonization by C. albicans and its rate of malignant transformation. We also searched the database in order to evaluate the efficacy of Photodynamic therapy against Candida infections. Case Presentation: The case presentation refers to a 37-year-old man with a diagnosis of tongue leukoplakia with a co-infection of C. albicans, treated with Photodynamic Therapy instead of conventional antifungal drugs. Results: The literature review was based on a total of 17939 articles, which were reduced to only 25 after setting the inclusion and exclusion criteria in several steps. Oral leukoplakia is an idiopathic condition that can be considered a precancerous lesion; its co-infection with C. albicans increases the chances of its malignant transformation. Photodynamic therapy is a new approach in terms of non-conventional therapies, and there is growing evidence that it can be used in the treatment of oral diseases, too. Conclusions: We eradicated the presence of C. albicans strains on our patient’s leukoplakia by using a mixture of photo-activated curcumin and H2O2, decreasing the chances of malignant transformation of our patient’s lesion, who is still undergoing a six-month control protocol.