Dermatologic surgeryToenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream
Section snippets
Patients
In all, 24 patients were enrolled in this prospective clinical trial. Participants were chosen from patients who had dystrophic nails that were clinically consistent with a fungal infection. To qualify for enrollment, subungual debris from the involved nail plate was obtained by using a small curette and then direct microscopy using 15% potassium hydroxide confirmed the fungal infection. All patients were not candidates for oral antifungal therapy because of drug interactions with other
Results
A total of 24 patients (16 female, 8 male) with an average age of 55.79 years (range, 29-68 years) were enrolled in this study. Although all patients had documented fungal infection based on potassium hydroxide examination of subungual debris at enrollment, 12 of these patients had samples submitted for fungal culture at enrollment. Cultures revealed 10 cases of Trichophyton rubrum, 1 case of Trichophyton mentagrophytes, and 1 case of Epidermophyton floccosum. The mean duration of the disease
Discussion
Onychomycosis is difficult to treat, and it has high rates of recurrence.1, 2 Treatment options for onychomycosis have historically included topical and oral antifungals.1 Topical therapies are limited by low efficacy because of subtherapeutic concentrations of antifungal medication reaching the nail bed.1, 2 Systemic antifungals are also limited in their use because of drug interactions and systemic adverse reactions.1, 2
In recent years, many laser systems have become available to physicians
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Supported by a grant from the Korea Ministry of Health and Welfare (A091121).
Conflicts of interest: None declared.