Gupta Aditya K, Paquet Maryse
Department of Medicine, University of Toronto , Toronto, Ontario , Canada and.
J Dermatolog Treat. 2015;26(4):376-8. doi: 10.3109/09546634.2014.975671. Epub 2014 Nov 5.
Cosmetic improvement in nail appearance is a great concern to patients with onychomycosis. Although oral and topical treatments for onychomycosis can potentially eradicate the infection, unsightly nails may remain despite negative mycology. Laser-based devices have been approved for the temporary clearance of nails with onychomycosis, thus providing a means of improving the aesthetic appearance of the nails. A retrospective chart review of patients treated with a Nd:YAG 1064-nm laser and debridement for onychomycosis, and terbinafine 1% cream for associated tinea pedis, between July 2012 and February 2014 was performed to ascertain the proportion of patients who achieved clinical outcomes. A temporary improvement in the appearance of the target nail was observed in 78% of patients and the affected area of the nail plate was reduced by at least 50% from baseline in 46% of patients. It appears that patients whose great toenails are potentially infected with non-dermatophyte molds may particularly benefit from laser therapy. Higher clinical outcome rates were observed with administration of four or more treatments, but additional observations and/or studies are needed to optimize the regimen of laser therapy to improve the cosmetic appearance of infected nails.
对于甲癣患者而言，指甲外观的美容改善是一个重大关切。尽管针对甲癣的口服和外用治疗有可能根除感染，但即便真菌学检查呈阴性，指甲可能仍会很难看。基于激光的设备已被批准用于暂时清除患有甲癣的指甲，从而提供一种改善指甲美观外观的方法。对2012年7月至2014年2月期间接受钕：钇铝石榴石1064纳米激光和清创术治疗甲癣、并用1%特比萘芬乳膏治疗相关足癣的患者进行了一项回顾性病历审查，以确定实现临床疗效的患者比例。78%的患者观察到目标指甲外观有暂时改善，46%的患者指甲板受累面积较基线减少至少50%。看来大脚趾甲可能感染非皮肤癣菌霉菌的患者可能特别受益于激光治疗。进行四次或更多次治疗时观察到更高的临床疗效，但需要更多观察和/或研究来优化激光治疗方案，以改善感染指甲的美观外观。
