title: The effectiveness of 1,064-nm long-pulsed Nd:YAG laser in the treatment of severe onychomycosis.
abstract: BACKGROUND
  Severe onychomycosis in the elderly is a common condition and generally difficult to treat. Long-pulsed Nd:YAG (LPNY) laser has been found to be useful in the treatment of onychomycosis. We sought to evaluate the effectiveness of 1,064-nm LPNY laser in the treatment of severe onychomycosis.
  
  
  METHODS
  Forty nails in 13 patients with severe onychomycosis were divided into two groups. Each group received eight treatment sessions at one-week intervals with 1,064-nm LPNY laser. Parameters for group A were 0.3 ms pulse duration, 5 mm spot size, 16 J/cm(2) fluence, and 10 Hz frequency, and those for group B were 0.6 ms, 2 mm, 225 J/cm(2), and 5 Hz. Clinical and mycological clearance were evaluated at 12 and 24 weeks after initial treatment.
  
  
  RESULTS
  Clinical improvements at 12 and 24 weeks presented 47.6 and 57.1% in group A, and 26.3 and 36.8% in group B. In the treated nails with clinical improvement, mycological positive rates at 24 weeks were approximately 40% in both groups.
  
  
  CONCLUSIONS
  The treatment of onychomycosis using 1,064-nm LPNY laser were incomplete in clinical and mycological improvement, and it could imply a lot of potential recurrence. We suggest that 1,064-nm LPNY laser for severe onychomycosis should need additional or combined therapy with other therapeutic options.
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Min Seok
authors.initials: MS
authors.lastname: Kim
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Jung
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Eun Byul
authors.initials: EB
authors.lastname: Cho
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Park
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Kim
authors.affiliation: a Department of Dermatology , College of Medicine, Hallym University , Anyang , Korea.
authors.forename: Kwang Joong
authors.initials: KJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D005533:Foot Dermatoses / Q000532:radiotherapy*; D006229:Hand Dermatoses / Q000532:radiotherapy*; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000528:radiation effects*; D014009:Onychomycosis / Q000532:radiotherapy*; D017060:Patient Satisfaction; D016896:Treatment Outcome
keywords: 1,064-nm long-pulsed Nd; YAG laser; laser therapy; onychomycosis