1340nm LASER THERAPY FOR ONYCHOMYCOSIS: Negative Results of Prospective Treatment of 72 Toenails and a Literature Review.

Autor: Espírito-Santo GAD; Drs. Espírito-Santo, Leite, Hoffmann-Santos, Dias, and Hahn are with the Faculty of Medicine, Post Graduate in Health Sciences at the Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil., Leite DP Jr; Drs. Espírito-Santo, Leite, Hoffmann-Santos, Dias, and Hahn are with the Faculty of Medicine, Post Graduate in Health Sciences at the Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil., Hoffmann-Santos HD; Drs. Espírito-Santo, Leite, Hoffmann-Santos, Dias, and Hahn are with the Faculty of Medicine, Post Graduate in Health Sciences at the Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil., Dias LB; Drs. Espírito-Santo, Leite, Hoffmann-Santos, Dias, and Hahn are with the Faculty of Medicine, Post Graduate in Health Sciences at the Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil., Hahn RC; Drs. Espírito-Santo, Leite, Hoffmann-Santos, Dias, and Hahn are with the Faculty of Medicine, Post Graduate in Health Sciences at the Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
Jazyk: angličtina
Zdroj: The Journal of clinical and aesthetic dermatology [J Clin Aesthet Dermatol] 2017 Aug; Vol. 10 (8), pp. 56-61. Date of Electronic Publication: 2017 Aug 01.
Abstrakt: Onychomycosis is an infection of the nail plate by fungal microorganisms. This infection has an important social impact on women and men and poses a major challenge for its treatment. The traditional treatment of onychomycosis involves the use of topical and oral antifungal agents. However, the presence of adverse effects frequently associated with oral antifungals, their high cost, and their potential interactions with other drugs reflect some of the problems associated with conventional therapy. The current report details the evaluation of a 1340nm laser as monotherapy for toenails affected by onychomycosis. A 1340nm, neodymium-yttrium:yttrium-aluminum-perovskite (Nd:YAP) (e) laser (Etherea, Industra technologies, Brazil) was used with the following treatment parameters: a spot size of 6mm, pulse duration of 5ms, fluence of 22 to 25J/cm 2 , and repetition rate of 1.5 to 2.5Hz. In all, 72 toenails were evaluated in 30 patients who had clinical and laboratory confirmation of onychomycosis. The efficacy of treatment was measured by the degree of patient satisfaction on a scale of 0 to 10 and by mycological cure evidenced by direct mycological exam and culture. Considering three applications of laser therapy and a clinical/laboratory follow-up period of 12 weeks, monotherapy with 1340nm laser was not effective, since 93.3 percent of the assessed patients remained without clinical and mycological cure. Despite reports of variable success rates with the use of different lasers for the treatment of onychomycosis, it is not yet possible to state that this therapeutic alternative is indicated for the treatment of these infections, mainly due to the limited number of patients and/or nail plates evaluated and the controversial results described in the literature.
Competing Interests: FUNDING:Financial support for this study was provided by FAPEMAT – Fundação de Amparo à Pesquisa no Estado de Mato Grosso (Foundation for the Support of Science of the State of Mato Grosso). DISCLOSURES:The authors have no conflicts of interest relevant to the content of this article.
Databáze: MEDLINE
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