title: Treatment of onychomycosis using a 1064nm Nd:YAG laser.
abstract: We investigated the efficacy of 1064nm Nd:YAG laser for the treatment of onychomycosis caused by dermatophytes. The study population consisted of 12 patients (6 male, 6 female ; average age 53.5 years), with onychomycosis confirmed by fungal culture and/or real-time PCR identification of the pathogen. The causative agent was identified as Trichophyton rubrum in 11 cases and a mixture of T. rubrum and T. mentagrophytes in 1 case. For each patient, laser treatment was given to a single hallux nail, with turbidity at baseline affecting <75% of the nail surface and thickness at baseline <3mm. Treatment was given in 3 sessions at 4-week intervals, and nail turbidity was evaluated 3 and 6 months after the first laser treatment. After 6 months the efficacy results were as follows: 3 cases, turbidity significantly improved ( >70%) ; 2 cases, turbidity improved (50-70%), 1 case, turbidity slightly improved (30-50%) ; 5 cases, no change in turbidity (<30% improvement) ; and 1 case, turbidity worsened. Overall, the total lesion area with turbidity in 12 patients decreased from 664.4mm(2) to 481.0mm(2), corresponding to a 27.6% improvement after treatment. Pain during laser treatment was well tolerated, and all patients underwent all 3 treatments. These results suggest that the 1064nm Nd:YAG laser could be a useful treatment alternative for patients with mild onychomycosis.
authors.affiliation: Noguchi Dermatology Clinic.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Noguchi
authors.forename: Keishi
authors.initials: K
authors.lastname: Miyata
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugita
authors.forename: Midori
authors.initials: M
authors.lastname: Hiruma
authors.forename: Masataro
authors.initials: M
authors.lastname: Hiruma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D014005:Tinea / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014249:Trichophyton / Q000302:isolation & purification