Abstract
Background:
Onychomycosis is a fungal infection of the nails. Oral itraconazole inhibits lanosterol-14α demethylase, impairing fungal cell membrane synthesis. The 1064 nm Q-switched Nd:YAG laser produces photothermolytic and photomechanical effects on fungi. Since both act via different mechanisms, their combination may offer additive benefits.
Objectives:
To compare the efficacy of oral itraconazole pulse therapy, 1064 nm Q-switched Nd:YAG laser therapy, and their combination in treating onychomycosis.
Methods:
Ninety Potassium hydroxide(KOH) mount- and culture-positive patients were randomized into 3 groups: itraconazole pulse (Group A), laser therapy (Group B), or combination therapy (Group C). Patients were followed for 9 months with 3-month interval assessments. Onychomycosis Severity Index (OSI), KOH mount, and culture were evaluated at each visit. Complete cure, clinical and mycological cure, effectiveness, and failure rates were compared.
Results:
All groups showed significant OSI reduction from baseline (P < .001), with no significant intergroup differences (P > .05). Clinical cure occurred in 20 patients (74.07%) in Group A, 20 (74.07%) in Group B, and 20 (80%) in Group C. No relapse occurred during follow-up. KOH and culture results did not differ significantly among groups.
Conclusion:
Laser therapy, alone or with itraconazole, was as effective as itraconazole pulse therapy. Given its efficacy and absence of systemic side effects, the Nd:YAG laser offers a safe alternative in managing onychomycosis.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
