Fotobiomodulação na síndrome de stevens-johnson no câncer de mama metastático: relato de caso

Abstract

Stevens-Johnson syndrome is a rare but potentially fatal condition, which requires early diagnosis and treatment to ensure good prognosis. Due to the complexity of the syndrome and the lack of a standard wound care treatment, the use of photobiomodulation has been discussed. Case report: A 30-year-old woman with metastatic breast cancer and Stevens-Johnson and Li-Fraumeni Like syndromes using photobiomodulation as an adjuvant strategy in the treatment of pain and skin wounds. The erythematous cutaneous lesions involved almost the entire body surface with painful, scaly, crusted and bullous lesions with bleeding spots in the posterior region of both ears lobes and in the occipital region which made it difficult to accommodate the patient in lateral decubitus and in semi-recumbent position. Two photobiomodulation applications (red, with a wavelength of 660 nm) were performed, where lesions in the occipital region and ears were treated with a dose of 2 Joules per point and 4 Joules in the scapular region for pain relief (infrared, with a wavelength of 808 nm), followed by mobilization and myofascial release in the scapular region. In 48 hours, the cutaneous lesions reduced, and the pain improved, which facilitated the adequate and painless positioning in bed. After 15 physiotherapy sessions, the patient was discharged. Conclusion: Photobiomodulation has been shown to be effective in the complementary treatment of the acute phase of Stevens-Johnson Syndrome regarding tissue regeneration and analgesia.