Treatment Outcomes of Combination Therapy with 1,064-nm Neodymium-doped Yttrium Aluminum Garnet Laser and Efinaconazole 10% Solution for Big Toenail Onychomycosis: a Retrospective Study
10.17966/JMI.2019.24.1.19
- Author:
Dong Hye SUH
1
;
Hyung Jin PARK
;
Sang Jun LEE
;
Hyunjoo KIM
;
Ki Heon JEONG
;
Mu Hyoung LEE
;
Min Kyung SHIN
Author Information
1. Arumdaun Nara Dermatologic Clinic, Seoul, Korea.
- Publication Type:Original Article
- From:Korean Journal of Medical Mycology
2019;24(1):19-27
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND:Laser therapy can be used as an alternative treatment for onychomycosis; however, there are somelimitations to its efficacy as a single agent.
OBJECTIVE:To evaluate the effectiveness of combination therapy with 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and topical efinaconazole in onychomycosis treatment and identify factors influencing the therapeutic outcomes of combination treatment.
METHODS:Big toenails with onychomycosis were treated by 1,064-nm Nd:YAG laser at 4-week intervals with daily application of topical efinaconazole. Therapeutic response was assessed through onychomycosis severity index (OSI) and percentage of nail infected (PNI), and its association with a variety of factors that may affect treatment outcome was evaluated.
RESULTS:One hundred big toenails were included in the study and significant clinical improvements were observed after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in treatment response according to the number of laser treatments, onychomycosis clinical type, or initial severity. However, patient age was negatively correlated with clinical improvement (p = 0.019). Also, female patients had better therapeutic responses than male patients.
CONCLUSION:Combined treatment with Nd:YAG laser and topical efinaconazole has a significant therapeutic effect on onychomycosis. A randomized controlled trial is warranted in the future.
