title: A retrospective chart review of the clinical efficacy of Nd:YAG 1064-nm laser for toenail onychomycosis.
abstract: Cosmetic improvement in nail appearance is a great concern to patients with onychomycosis. Although oral and topical treatments for onychomycosis can potentially eradicate the infection, unsightly nails may remain despite negative mycology. Laser-based devices have been approved for the temporary clearance of nails with onychomycosis, thus providing a means of improving the aesthetic appearance of the nails. A retrospective chart review of patients treated with a Nd:YAG 1064-nm laser and debridement for onychomycosis, and terbinafine 1% cream for associated tinea pedis, between July 2012 and February 2014 was performed to ascertain the proportion of patients who achieved clinical outcomes. A temporary improvement in the appearance of the target nail was observed in 78% of patients and the affected area of the nail plate was reduced by at least 50% from baseline in 46% of patients. It appears that patients whose great toenails are potentially infected with non-dermatophyte molds may particularly benefit from laser therapy. Higher clinical outcome rates were observed with administration of four or more treatments, but additional observations and/or studies are needed to optimize the regimen of laser therapy to improve the cosmetic appearance of infected nails.
authors.affiliation: Department of Medicine, University of Toronto , Toronto, Ontario , Canada and.
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Maryse
authors.initials: M
authors.lastname: Paquet
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003646:Debridement; D005260:Female; D005533:Foot Dermatoses / Q000628:therapy*; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage; D014009:Onychomycosis / Q000628:therapy*; D012189:Retrospective Studies; D000077291:Terbinafine; D016896:Treatment Outcome
chemical_list: D009281:Naphthalenes; D000077291:Terbinafine
keywords: Clinical improvement; fungal infection; great toenail; laser; onychomycosis; retrospective