Olivas-Altamirano MD, Ávila-Romay A, Vega-Sánchez DC, Ramírez AL, Juárez-Durán ER, Arenas R

Language: Spanish
References: 12
Page: 195-198
PDF size: 168.63 Kb.

ABSTRACT

Background: onychomycosis, a fungal infection primarily affecting toenails (70% of cases), commonly presents as distal subungual onychomycosis and total dystrophic onychomycosis, predominantly caused by Trichophyton rubrum. Current treatments include topical or systemic antifungals. Laser therapy, specifically the Nd:YAG Q-switched 1 064 nm laser, serves as an adjuvant, enhancing nail quality with minimal side effects.
Objective: this study aimed to evaluate the efficacy of the Nd:YAG Q-switched 1 064 nm laser in treating toenail onychomycosis over at least three sessions, without concurrent treatments.
Materials and methods: We conducted an observational, descriptive study involving 11 patients aged 19 to 72 years (average age: 52 years of age with onychomycosis confirmed by positive direct examination with chlorazol black and/or culture. After obtaining informed consent, photographic records were taken before and after each laser session. Treatment utilized a Spectra Nd:‹ Q-switched laser (1 064 nm wavelength) with parameters of 5.5 Hz and 7.5 j, delivering 500 shots to the first toe and 300 shots to other affected toes. The onychomycosis severity index (OSI) scale was used for outcome comparison.
Results: among the 11 patients, seven presented with total onychodystrophy and four with distal subungual onychomycosis. Unilateral involvement was predominant (54.5%), and the first toe was the most frequent treatment site (72.7%). Only two patients completed the full protocol of three sessions spaced three weeks apart, showing no significant changes in the onychomycosis itself. However, a noticeable improvement in nail coloration and texture was observed.
Conclusions: while three sessions of Nd:YAG Q-switched 1 064 nm thermolysis laser improved nail quality, appearance, coloration, and texture in onychomycosis, it did not significantly alter the primary onychomycosis parameters.

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