Antifungal efficacy of lasers against dermatophytes and yeasts<i>in vitro</i>

Paasch, Uwe; Mock, Andrea; Grunewald, Sonja; Bodendorf, Marc Oliver; Kendler, Michael; Seitz, Anna-Theresa; Simon, Jan C.; Nenoff, P.

doi:10.3109/02656736.2013.823672

Cited by 38 publications

(25 citation statements)

References 35 publications

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“…The development of lasers for onychomycosis is at an important phase, as primary research on fungal chromophores, the thermal properties of fungal hyphae and a clear understanding of laser penetrance through an infected nail plate are crucial to the achievement of effective selective photothermolysis. The results of early in vitro and in vivo studies of lasers in onychomycosis have mostly yielded poor results (2,(29)(30)(31)(32). This is attributable to the use of non-optimal, preexisting laser systems being applied for a new indication without regard for optimization to the fungal target.…”

Section: Discussionmentioning

confidence: 95%

The future of lasers in onychomycosis

Gupta

Simpson

2015

Journal of Dermatological Treatment

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Section: Discussionmentioning

confidence: 95%

The future of lasers in onychomycosis

Gupta

Simpson

2015

Journal of Dermatological Treatment

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“…In a study of Paasch et al [8], the highest increase in temperature in a 980-nm laser was found with a pulse of 6 ms and a fluence of 27 J/cm 2 , with an inhibition of growth for Candida guilliermondii and T. interdigitale only at temperatures >50°C. All other pathogenic germs showed reduced, but not inhibited growth, and C. albicans showed no impact at all.…”

Section: Discussionmentioning

confidence: 99%

1,064-nm Diode Laser Therapy of Onychomycosis: Results of a Prospective Open Treatment of 82 Toenails

Renner

Grüsser

Sticherling³

2015

Dermatology

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Background: Onychomycosis is one of the most prevalent nail disorders in adults, where conventional topical therapy is often protracted and in most cases ineffective. On the other hand, systemic/oral therapy is not suitable for all patients and might be associated with relevant side effects. Therefore, laser therapy can be used as an alternative to or extension of existing treatment protocols. Objectives: We used diode laser treatment for onychomycosis to evaluate the efficacy of this treatment as single therapy as well as in combination with an ongoing antimycotic treatment. Methods: We used a 1,064-nm diode laser (FOX Laser, ARC Laser GmbH, Germany) in pulse mode with a spot size of 4 mm. The laser's settings were: 8 W, with a pulse duration of 80 ms and a repetition rate of 5.6 Hz; the energy fluence/pulse was 5.1 J/cm², and a total energy of 250-500 J for large and/or thickened nails (digit I), 120-200 J for medium nails (digits II-IV) and 60-120 J for small and/or very thin nail plates (digit V) was counted in the laser display. Two to three passes where applied continuously over the entire area of the nail (nail plate, nail folds and eponychium) in a grid pattern. Eighty-two affected toenails were treated at least twice every 8 weeks; all nails treated were clinically diagnosed as onychomycosis. The evaluation of the treated nails was conducted by two dermatologists, initially by semiquantitative visual examination, followed by evaluation with the Onychomycosis Severity Index (OSI). In addition, the patients were asked to state their satisfaction with the treatment and its results in a written questionnaire. Results: All nails showed an improvement ranging between 14 and 56% including the analytical evaluation scale (OSI). Two dermatologists evaluated 34 nails. Both reported significant improvement and/or good clinical improvement, which corresponds to about 41% for both evaluations. The mean OSI of all patients was 18.9/19.9 before treatment which changed to 14.3/14.8 after treatment. This corresponds to an improvement of about 25% (-4.6/-5.1) compared to the initial value. Specifically the subgroup with positive antimycotic culture and no additional antimycotic treatment showed an improvement of about 25%. This improvement can be attributed to the effect of the diode laser treatment. When evaluating the OSI of all nails, it appears that about 15-20% of the severe OSIs improved and changed to a moderate level, while a similar portion of patients with moderate onychomycosis improved to mild onychomycosis. Patient satisfaction was measured to an average value of 4.6 out of a maximum of 10 points. About 60% of the treated patients would recommend the treatment to their family members or friends. Conclusion: This investigation demonstrated that diode laser treatment of onychomycosis provides acceptable results with minimal to no side effects. Further clinical evaluations could help to establish better therapy protocols, especially for those patients who had no benefit from the laser treatment, or co...

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“…Oceniano zahamowanie wzrostu kolonii grzybów T. rubrum po jednokrotnym zabiegu, a zamierzony efekt osiągnięto przy zastosowaniu lasera Nd:YAG 1064 nm (4 J/cm 2 i 8 J/cm 2 ), Nd:YAG 532 nm (8 J/cm 2 ), a także pulsacyjnego lasera barwnikowego 595 nm (8 J/cm 2 i 14 J/cm 2 ). Zaobserwowano, że lasery generujące promieniowanie o długości 808 nm i 980 nm powodują podgrzanie medium hodowli, również hodowli grzybów, a wykorzystanie większej energii przynosi lepsze efekty, ale może być bardziej bolesne [14]. Autorzy zwrócili uwagę na fakt, że naświetlanie nie zawsze powoduje inaktywację grzybów, zwłaszcza T. rubrum i T. interdigitale.…”

Section: Promieniowanie Laserowe W Leczeniu Grzybicy Paznokciunclassified

“…Autorzy zwrócili uwagę na fakt, że naświetlanie nie zawsze powoduje inaktywację grzybów, zwłaszcza T. rubrum i T. interdigitale. Niekiedy może dochodzić do wzrostu kolonii grzybów po naświetlaniach, co autorzy łączą z możliwością wystąpienia efektu biostymulującego [14].…”

Section: Promieniowanie Laserowe W Leczeniu Grzybicy Paznokciunclassified

Novel light therapies in treatment of onychomycosis

Erkiert‐Polguj¹,

Algiert²,

Rotsztejn³

2016

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Przegląd Dermatologiczny 2016/3 246 STRESZCZENIE Grzybica paznokci jest częstą chorobą dotyczącą aparatu paznokciowego, a jej leczenie wg obecnie obowiązujących standardów nie zawsze przynosi zadowalające efekty. Celem pracy jest zwrócenie uwagi na nowe możliwości terapii z wykorzystaniem promieniowania laserowego, promieniowania ultrafioletowego typu C, a także terapii fotodynamicznej. Najwięcej danych piśmiennictwa dotyczy wykorzystania lasera neodymowo-yagowego, a także laserów diodowych lub ablacyjnego lasera dwutlenkowo-węglowego. Niektórzy autorzy, aby poprawić skuteczność leczenia, stosowali przed zabiegiem usuwanie mas grzybiczych lub dołączali miejscowe leczenie preparatami przeciwgrzybiczymi. Ponadto przedstawiono metodę fotodynamiczną wykorzystywaną w leczeniu stanów przednowotworowych i powierzchownych nowotworów skóry, która daje obiecujące wyniki w terapii grzybicy paznokci z zastosowaniem tych samych lub innych fotouczulaczy. Uzyskane przez autorów efekty leczenia i brak poważnych działań ubocznych zachęcają do stosowania tego typu terapii, ale żadna z metod do tej pory nie została porównana z leczeniem farmakologicznym wg aktualnych wytycznych. ABSTRACTOnychomycosis is a frequent nail disease. Standard treatment is not sufficient in some patients. The aim of the study is to provide an overview of laser, UVC and photodynamic therapy of onychomycosis. The use of Nd:YAG laser is described in many articles, and also diode lasers and ablative CO 2 are used. Some authors, in order to improve the efficiency of treatment, also administered topical antifungal therapy or removed a part of the nail. Also photodynamic therapy usually used in precancerous diseases or superficial skin tumors is also employed in onychomycosis with the same or new photosensitizers. The results and the lack of serious side effects encourage the use of these methods, although none has been compared to standard oral therapy. SŁOWA KLUCZOWE:terapia fotodynamiczna, laser, grzybica paznokci, UVC.

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Antifungal efficacy of lasers against dermatophytes and yeastsin vitro

Cited by 38 publications

References 35 publications

The future of lasers in onychomycosis

The future of lasers in onychomycosis

1,064-nm Diode Laser Therapy of Onychomycosis: Results of a Prospective Open Treatment of 82 Toenails

Novel light therapies in treatment of onychomycosis

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