Effects Of Nd:YAG1064nm Laser Treatment On Onychomycosis

Background:Onychomycosis is a fungal infection of nail plate or nail bed. The conventional therapeutic options for the disease include application of systemic and topical antifungal agents, mechanical or chemical debridement and so on. To a certain extent, the methods mentioned above still have lots of deficiencies, such as long course of treatment, poor compliance, poor efficacy and pain.With the rapid development of medical laser techniques, several safe laser devices with good effect have been approved by the U.S. Food and Drug Administration (food and drug administration, FDA),and now approved for treating onychomycosis. Recalling the systemic antifungal agents treatment of onychomycosis, course of treatment for toenails is longer than fingernails. The laser treatment of onychomycosis didn’t come up with the difference between fingernails and toenails.Objective:We will compare the clinical efficacy between fingernails and toenails to establish the laser treatment of onychomycosis.Methods:Collect the fingernails cases and toenail cases, and the nails should be divided into several subgroups according to SCIO, every case with8-treatment times. Treating onychomycosis with laser are reviewed, especially with1064nm Nd-YAG laser, energy density:50-60J/cm2, spot size:2mm, pulse35ms, frequency1.5Hz. Observed in the difference of treatment effect in fingernails and toenails.8weeks,16weeks,24weeks for mycological examination. Contrast differences in the efficiency of hand, foot, and to compare the efficacy of different subgroups.Results:The test collectde112nails,50of them was fingernail,62of them was toenail. After24weeks of treatment, the mycological cure rate of fingernail was74%, toenail was83.9%1. After24weeks of treatment, there was obviously difference between fingernail and toenail on clinical efficiency. The clinical effective rate was71%for toenails and52%for fingernails. The same severity degree (Ⅲ degree), after treatment, toenails show a better effective rate than fingernails. The effective rate of toenail was84.8%. The effective rate of fingernail was52%. Trichophyton rubrum infectde nail was more sensitive to laser treatment. Trichophyton rubrum group show the effective rate of treatment was68.7%, Candida albicans group was58.8%.Conclusion:1. Laser treatment of onychomycosis overall effective;2. The effective rate of laser treatment was different between fingernail and toenail. Toenail’s effective rate was higher than fingernail.3. The effective rate was associated with the site of infection (hand/foot) and strain. Trichophyton rubrum infected nail was more sensitive to laser treatment.4. In the same infectious degree, there was no significant difference between fingernails and toenails.