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Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer

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Abstract

Onychomycosis remains difficult to cure by traditional methods. The aim of this study was to evaluate the efficacy of combination therapy with a fractional erbium yttrium aluminum garnet (Er:YAG) laser and 5 % amorolfine lacquer on onychomycosis. Nine patients with bilateral nails affected by distal and lateral subungual onychomycosis were included. The bilateral nails of each patient were divided into two groups. The 20 affected nails on one side of each patient as group 1 were treated with a fractional Er:YAG laser once a week and 5 % amorolfine lacquer twice weekly, while the 20 nails on the symmetrical side of each patient as group 2 were treated with amorolfine lacquer only. The laser treatment was conducted at weeks 1, 2, 3, 4, 8, and 12 in group 1. The clinical improvement, onychomycosis severity index (OSI), maximum linear clear nail growth (MLCNG), and mycological cure rate were evaluated. At week 24, 18 of 20 (90 %) nails in group 1 had achieved obvious clinical responses. The mean OSI score showed a significant decrease (5.24) and the average MLCNG was 3.1 mm in group 1. At week 24, 15 of 20 (75 %) nails achieved a negative mycological examination in group 1, compared with four of 20 (20 %) nails in group 2. The treatments were well-tolerated by most patients. This clinical study suggests that combination therapy of a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer is an effective, safe, and convenient treatment method for onychomycosis.

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Acknowledgments

We thank Dr. Kana Chen for her help in modifying the photographs and Dr. Shujie Xie for his helpful suggestions for improving the paper.

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    Authors and Affiliations

    1. Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, West Yanjiang Road 107, Yuexiu District, Guangzhou, Guangdong Province, China

      Jing Zhang, Sha Lu, Xiqing Li, Wenying Cai, Jianchi Ma & Liyan Xi

    2. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

      Jing Zhang & Sha Lu

    3. Department of Dermatology and Venereology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China

      Huaiqiu Huang

    Authors
    1. Jing Zhang
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    2. Sha Lu
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    3. Huaiqiu Huang
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    4. Xiqing Li
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    5. Wenying Cai
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    7. Liyan Xi
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    Correspondence to Liyan Xi.

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    Ethics statement

    This study was approved by the Institutional Review Board of Sun Yat-sen Memorial Hospital of Sun Yat-sen University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Financial support

    This study was supported by a grant from the Shenzhen Scientific and Technological Innovation Project (JCYJ20140411092351699).

    Additional information

    Jing Zhang and Sha Lu contributed equally to this work.

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    Cite this article

    Zhang, J., Lu, S., Huang, H. et al. Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5 % amorolfine lacquer. Lasers Med Sci 31, 1391–1396 (2016). https://doi.org/10.1007/s10103-016-1990-z

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    • DOI: https://doi.org/10.1007/s10103-016-1990-z

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