title: Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer.
abstract: Onychomycosis remains difficult to cure by traditional methods. The aim of this study was to evaluate the efficacy of combination therapy with a fractional erbium yttrium aluminum garnet (Er:YAG) laser and 5 % amorolfine lacquer on onychomycosis. Nine patients with bilateral nails affected by distal and lateral subungual onychomycosis were included. The bilateral nails of each patient were divided into two groups. The 20 affected nails on one side of each patient as group 1 were treated with a fractional Er:YAG laser once a week and 5 % amorolfine lacquer twice weekly, while the 20 nails on the symmetrical side of each patient as group 2 were treated with amorolfine lacquer only. The laser treatment was conducted at weeks 1, 2, 3, 4, 8, and 12 in group 1. The clinical improvement, onychomycosis severity index (OSI), maximum linear clear nail growth (MLCNG), and mycological cure rate were evaluated. At week 24, 18 of 20 (90 %) nails in group 1 had achieved obvious clinical responses. The mean OSI score showed a significant decrease (5.24) and the average MLCNG was 3.1 mm in group 1. At week 24, 15 of 20 (75 %) nails achieved a negative mycological examination in group 1, compared with four of 20 (20 %) nails in group 2. The treatments were well-tolerated by most patients. This clinical study suggests that combination therapy of a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer is an effective, safe, and convenient treatment method for onychomycosis.
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China.|Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China.|Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Sha
authors.initials: S
authors.lastname: Lu
authors.affiliation: Department of Dermatology and Venereology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Huaiqiu
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China.
authors.forename: Xiqing
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China.
authors.forename: Wenying
authors.initials: W
authors.lastname: Cai
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China.
authors.forename: Jianchi
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China. xiliyan@medmail.com.cn.
authors.forename: Liyan
authors.initials: L
authors.lastname: Xi
mesh_terms: D000328:Adult; D000368:Aged; D000535:Aluminum; D000935:Antifungal Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004871:Erbium; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007764:Lacquer; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D009262:Nails / Q000254:growth & development / Q000382:microbiology; D014009:Onychomycosis / Q000532:radiotherapy*; D055815:Young Adult; D015019:Yttrium
chemical_list: D000935:Antifungal Agents; D009025:Morpholines; C503779:yttrium-aluminum-garnet; D015019:Yttrium; D004871:Erbium; C038974:amorolfine; D000535:Aluminum
keywords: Amorolfine; Fractional Er:YAG laser; Laser therapy; Onychomycosis