Laser treatment has emerged as a novel treatment modality for onychomycosis.
We sought to determine thermal response and optical effects of a submillisecond neodymium:yttrium-aluminum-garnet (Nd:YAG) 1064-nm laser on common fungal nail pathogens, and the clinical efficacy and safety of the Nd:YAG 1064-nm laser on onychomycotic toenails.
A 4-part in vitro and in vivo study was conducted using a Nd:YAG 1064-nm laser. The first portion evaluated 3 different nail pathogens in suspension at 7 heat and time exposures. The second and third parts of the study irradiated pure fungal colonies. The final portion involved an in vivo treatment of toenails over 5 treatment sessions.
A fungicidal effect for Trichophyton rubrum was seen at 50°C after 15 minutes, and for Epidermophyton floccosum at 50°C after 10 minutes. Limited growth of Scytalidium was seen at 55°C after 5 minutes. No inhibition was observed after laser treatment of fungal colonies or suspensions. In vivo treatment of toenails showed no improvement in Onychomycosis Severity Index score.
The Nd:YAG 1064-nm laser was the only laser tested.
Laser treatment of onychomycosis was not related to thermal damage or direct laser effects. In vivo treatment did not result in onychomycosis cure.Le texte complet de cet article est disponible en PDF.
Key words : fungal, irradiation, laser, neodymium:yttrium-aluminum-garnet, onychomycosis, Onychomycosis Severity Index, thermal
Abbreviations used : CFU, Nd:YAG, OSI
| Supported by Cutera Inc, Brisbane, CA.
| Disclosure: Dr Elewski has received grants from Cutera Inc and Anacor Pharmaceuticals Inc, and a grant and honoraria from Valeant Pharmaceuticals International Inc. Drs Carney and Cantrell and Ms Warner have no conflicts of interest to declare.
| In vitro results were presented as a poster at the American Academy of Dermatology Annual Meeting, Miami Beach, FL, March 5-10, 2010.