Korean J Med Mycol.  2019 Mar;24(1):19-27. 10.17966/JMI.2019.24.1.19.

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

Affiliations
  • 1Arumdaun Nara Dermatologic Clinic, Seoul, Korea.
  • 2Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea. haddal@hanmail.net

Abstract

BACKGROUND
Laser therapy can be used as an alternative treatment for onychomycosis; however, there are some limitations 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.

Keyword

Combination treatment; Laser; Onychomycosis

MeSH Terms

Aluminum*
Female
Humans
Laser Therapy
Male
Nails*
Onychomycosis*
Retrospective Studies*
Treatment Outcome
Yttrium*
Aluminum
Yttrium
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