Innovative Physical Approaches for Onychomycosis: Peeling, Lasers and Beyond

Sonthalia, Sidharth; Goldust, Mohamad

doi:10.1159/000497044

Cited by 1 publication

(2 citation statements)

References 27 publications

(20 reference statements)

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“…Topical treatments should also be used for treatment of white superficial onychomycosis. In these cases, among the innovative physical approaches for moderate onychomycoses are nail peeling, 7 thermal disruption of fungal biofilm by lasers and photochemical damage by photodynamic therapy (PDT) 8 . Lasers can elicit a fungicidal effect by photothermally heating the fungal mycelium through selective photothermolysis 9,10 .…”

Section: Introduccionmentioning

confidence: 99%

“…In these cases, among the innovative physical approaches for moderate onychomycoses are nail peeling, 7 thermal disruption of fungal biofilm by lasers and photochemical damage by photodynamic therapy (PDT). 8 Lasers can elicit a fungicidal effect by photothermally heating the fungal mycelium through selective photothermolysis. 9,10 PDT is a noninvasive therapy that requires light activation of a photosensitizer (PS) in the presence of oxygen which generates reactive oxygen species leading to selective and highly localized destruction of "abnormal" cells by necrosis or apoptosis.…”

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confidence: 99%

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Methylene blue vs methyl aminolevulinate photodynamic therapy in the treatment of mild‐to‐moderate toenail onychomycosis: Short‐ and medium‐term effects

Alberdi¹,

Gómez

2020

Dermatologic Therapy

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Photodynamic therapy (PDT) has emerged as an interesting alternative option for onychomycosis treatment. The impact of a specific photosensitizer (PS) on the final result is an important factor to consider. We conducted a short-and medium-term controlled trial to compare the effectiveness of PDT in the treatment of mild-tomoderate onychomycosis when it is mediated by two different PSs. Twenty patients were randomized to receive nine sessions of PDT distributed over 16 weeks mediated either by methylene blue (MB/PDT group) or methyl aminolevulinate (MAL/ PDT group). Onychomycosis severity index (OSI) and nail involvement were checked along the study. Complete cure, treatment success, and clinical improvement were tabulated at 16 and 40-week follow-ups. OSI scores decreased significantly along the study, from 12.1 ± 5.4 to 3.6 ± 3.2 (MB/PDT group) and from 14.8 ± 6.0 to 5.4 ± 4.4 (MAL/PDT group). At 16-week follow-up, only 20% of the patients in the MB/PDT group reached complete cure and none in the group of MAL/PDT. At 40-week follow-up, complete cure rates were 70% and 40% in the MB/PDT group and MAL/PDT group respectively. Both modalities showed good outcomes in treatment of moderate toenail onychomycosis. MB/PDT showed a faster action but with relapse rates slightly higher than MAL/PDT.

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Section: Introduccionmentioning

confidence: 99%

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confidence: 99%