title: Treatment of onychomycosis using the 1 064 nm Nd:YAG laser: a clinical pilot study.
abstract: BACKGROUND
  Nd:YAG lasers could be a safe and effective treatment modality for onychomycosis, without the side effects of drugs. Long and short-pulsed Nd:YAG lasers were used in this clinical study in a side-comparison manner without removal of onychomycotic nail material before treatment.
  
  
  METHODS
  Big toenails of 10 patients were treated twice in a side-comparison manner with the short-pulsed Nd:YAG laser. Fungal cultures were taken and a histological examination was performed before treatment and after 9 months. Two independent investigators rated clearance using the "Onychomycosis Severity Index (OSI)" and standardized photographs at 3-month intervals.
  
  
  RESULTS
  OSI-Scores decreased for 3.8 (15 %; p = 0.006), 4.8 (19 %; p = 0.0002) and 2.9 points (12 %; p = 0.04) within 3, 6 and 9 months. The positive culture rate at 9 months was significantly reduced to 35 % (p = 0.0003). Classification of severity of onychomycosis showed no change. The difference between the treatment regimens was not significant.
  
  
  CONCLUSIONS
  These results suggest that treatment of onychomycosis with the Nd:YAG laser without removing mycotic nail material can lead to a temporary clinical improvement, a reduction of positive fungal cultures and an improvement of the Onychomycosis Severity Index. The treatment regimen should be optimized to be used as an effective antimycotic monotherapy.
authors.affiliation: Laserklinik Karlsruhe.
authors.forename: Henrik
authors.initials: H
authors.lastname: Hees
authors.forename: Michael W
authors.initials: MW
authors.lastname: Jäger
authors.forename: Christian
authors.initials: C
authors.lastname: Raulin
mesh_terms: D000368:Aged; D005260:Female; D005533:Foot Dermatoses / Q000382:microbiology / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000382:microbiology / Q000473:pathology* / Q000532:radiotherapy*; D010865:Pilot Projects; D016896:Treatment Outcome