title: Self-controlled Study of Onychomycosis Treated with Long-pulsed Nd:YAG 1064-nm Laser Combined with Itraconazole.
abstract: BACKGROUND
  Onychomycosis is a fungal infection of the nail plate and subungual area. In this study, we examined the efficacy of laser treatment using self-controlled study programs involving a long-pulsed Nd:YAG 1064-nm laser combined with oral medication.
  
  
  METHODS
  Self-controlled strategies were followed in this study. The patients received treatment with oral itraconazole in conjunction with long-pulsed Nd:YAG 1064-nm laser treatment at the nails of the unilateral limb once a week for a total of four times. A total of 84 affected nails were divided into Group A (mild to moderate) and Group B (severe) according to disease severity. Affected nails with the same Scoring Clinical Index for Onychomycosis scores were selected to compare the therapeutic effects of the pure medication treatment group and the combination treatment group with a 24-week follow-up period.
  
  
  RESULTS
  In Group A, at the 8th, 16th, and 24th weeks of follow-up, the efficacies in the pure medication treatment group were 81.0%, 81.0%, and 90.5%, respectively, while those in the combination treatment group were 100%, 95.2%, and 90.5%, respectively. The differences between groups were not significant (8th week: χ2 = 4.421, P> 0.05; 16th week: χ2 = 2.043, P> 0.05; 24th week: χ2 = 0.00, P > 0.05). In Group B, at the 8th, 16th, and 24th weeks of follow-up, the efficacies in the pure medication treatment group were 61.9%, 66.7%, and 52.4%, respectively, while those in the combination treatment group were 95.2%, 90.5%, and 100%, respectively. The differences between groups at the 8th and 24th weeks of follow-up were statistically significant (8th week: χ2 = 6.929, P< 0.05; 24th week: χ2 = 13.125, P < 0.05).
  
  
  CONCLUSIONS
  For patients with mild or moderate onychomycosis, we recommended a pure medication treatment or combination treatment with medication and laser. For those patients with severe onychomycosis, we recommended a combination of medication and laser therapy.
authors: Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors: Yan
authors: Y
authors: Li
authors: Department of Dermatology, Capital Institute of Pediatrics, Beijing 100020, China.
authors: Jing
authors: J
authors: Xu
authors: Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors: Jun-Ying
authors: JY
authors: Zhao
authors: Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors: Feng-Lin
authors: FL
authors: Zhuo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000188:drug therapy* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole