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KMID : 1145920190240010019
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Journal of Mycology and Infection
2019 Volume.24 No. 1 p.19 ~ p.27
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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
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Suh Dong-Hye
Park Hyung-Jin
Lee Sang-Jun
Kim Hyun-Joo
Jeong Ki-Heon
Lee Mu-Hyoung
Shin Min-Kyung
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Abstract
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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.
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KEYWORD
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Combination treatment, Laser, Onychomycosis
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