title: Combined oral terbinafine and long-pulsed 1,064-nm Nd: YAG laser treatment is more effective for onychomycosis than either treatment alone.
abstract: BACKGROUND
  Onychomycosis is difficult to cure. Systemic and topical treatments, including the 1,064-nm Nd:YAG laser, are not very effective when used individually.
  
  
  OBJECTIVE
  To compare the efficacy and safety of combined treatment with a long-pulsed 1,064-nm Nd:YAG laser and oral terbinafine with those of either treatment alone.
  
  
  METHODS
  We randomly divided 53 patients with a total of 90 infected nails into 3 treatment groups: the T group received oral terbinafine, the L group received long-pulsed Nd:YAG laser treatment, and the T + L group received both treatments. We evaluated the mycological clearance rate (MCR) and the clinical clearance rate (CCR) of the 3 groups at Weeks 4, 8, 12, 16, and 24.
  
  
  RESULTS
  The MCR and CCR increased in all 3 groups in a time-dependent manner. The MCR and CCR of the T + L group were significantly higher than those of the T group and the L group at Weeks 8, 12, 16, and 24 (p < .05).
  
  
  CONCLUSIONS
  These data indicate that 12 weeks of combined treatment with a long-pulsed Nd:YAG laser and oral terbinafine produce more rapid and effective mycological and clinical clearance in patients with onychomycosis than either treatment alone, without any obvious side effects.
authors.affiliation: *Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; †Department of Dermatology, The Second Affiliated Hospital of Nantong University, Nantong, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xu
authors.forename: Xu
authors.initials: X
authors.lastname: Miao
authors.forename: Bingrong
authors.initials: B
authors.lastname: Zhou
authors.forename: Dan
authors.initials: D
authors.lastname: Luo
mesh_terms: D000284:Administration, Oral; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D009281:Naphthalenes / Q000008:administration & dosage*; D014009:Onychomycosis / Q000188:drug therapy / Q000382:microbiology / Q000532:radiotherapy / Q000628:therapy*; D000077291:Terbinafine
chemical_list: D009281:Naphthalenes; D000077291:Terbinafine