Randomized Clinical Trial to Evaluate the Efficacy and Safety of Combination Therapy with Short-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminium Garnet Laser and Amorolfine Nail Lacquer for Onychomycosis

Kui Young Park; 서준혁; 김범준; KimMyeungNam; 홍창권

Randomized Clinical Trial to Evaluate the Efficacy and Safety of Combination Therapy with Short-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminium Garnet Laser and Amorolfine Nail Lacquer for Onychomycosis

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Type: Academic journal

Author: Kui Young Park 서준혁 김범준 KimMyeungNam 홍창권

Journal: Korean Dermatological Association Annals of Dermatology Annals of Dermatology 제29권 제6호 KCI Accredited Journals SCOPUS

Published: 2017.1

Pages: 699 - 705 (7page)

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Randomized Clinical Trial to Evaluate the Efficacy and Safety of Combination Therapy with Short-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminium Garnet Laser and Amorolfine Nail Lacquer for Onychomycosis

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Background: Onychomycosis is one of the most prevalent fungal diseases in the general population. However, treatment is of limited effectiveness and must be administered for long periods of time. Systemic antifungal agents are associated with adverse effects. Objective: We evaluated the clinical efficacy and safety of a 1,064-nm neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with amorolfine nail lacquer to treat onychomycosis. Methods: The 128 patients were randomly divided to 2 groups: 64 in the experimental group were treated with 1,064-nm Nd:YAG laser therapy and amorolfine nail lacquer; the other 64 were in a control group treated with topical amorolfine lacquer monotherapy. The laser treatment was 4 sessions at 4-week intervals and amorolfine lacquer was applied once a week for 16 weeks. Efficacy was assessed as response rate from standardized photographs with ImageProⓇPlus (Media Cybernetics, Inc., USA) analysis, microscopic examination, and subjective evaluation. Results: At 16 weeks, the experimental group showed a significantly higher cumulative cure rate than the control group (71.88% vs. 20.31%, p ＜0.0001). Clinical therapeutic effects were linked to patient satisfaction. The percent of "very satisfied" or "satisfied" responses was higher in the test group than the control group (81.25% vs. 23.44%). The treatment regimen was well tolerated, with transient discomfort observed in the test group. Conclusion: The 1,064-nm Nd:YAG laser with amorolfine nail lacquer was effective and safe for treating onychomycosis. This therapy should be considered an alternative treatment, especially for patients with contraindications to systemic antifungal agents.

#Lasers #Onychomycosis #Therapeutics #Topical antifungal agent

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Carney C / 2013 / Treatment of onychomycosis using a submillisecond 1064-nm neodymium:yttrium-aluminum-garnet laser / J Am Acad Dermatol 69 : 578 ~ 582

El-Tatawy RA / 2015 / A comparative clinical and mycological study of Nd-YAG laser versus topical terbinafine in the treatment of onychomycosis / J Dermatolog Treat 26 : 461

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