Zalacain Antonio, Merlos Alejandra, Planell Elena, Cantadori Erica G, Vinuesa Teresa, Viñas Miguel
Department of Pathology and Experimental Therapeutics, Campus de Ciències de la Salut de Bellvitge, University of Barcelona, Barcelona, Spain.
Department of Podiatry, Campus de Ciències de la Salut de Bellvitge, University of Barcelona, Barcelona, Spain.
Lasers Med Sci. 2018 May;33(4):927-933. doi: 10.1007/s10103-017-2198-6. Epub 2017 Apr 4.
Onychomycoses are fungal infections of the fingernails or toenails having a prevalence of 3% among adults and accounts for 50% of nail infections. It is caused by dermatophytes, non-dermatophyte filamentous fungi, and yeasts. Compressions and microtraumas significantly contribute to onychomycosis. Laser and photodynamic therapies are being proposed to treat onychomycosis. Laser light (1064 nm) was used to treat onychomycosis in 156 affected toenails. Patients were clinically followed up for 9 months after treatment. Microbiological detection of fungal presence in lesions was accomplished. A total of 116 samples allowed the isolation of at least a fungus. Most of nails were affected in more than two thirds surface (some of them in the full surface). In 85% of cases, after 18 months of the onset of treatment, culture turned negative. After 3 months months, only five patients were completely symptom-free with negative culture. In 25 patients, only after 6 months, the absence of symptoms was achieved and the cultures negativized; in 29 patients, 9 months were required. No noticeable adverse effects were reported. This study reinforces previous works suggesting the applicability of laser therapies to treat toenail onychomycosis.
甲癣是指甲或趾甲的真菌感染，在成年人中的患病率为3%，占指甲感染的50%。它由皮肤癣菌、非皮肤癣菌丝状真菌和酵母菌引起。压迫和微创伤是甲癣的重要诱因。目前有人提出用激光和光动力疗法来治疗甲癣。用波长1064纳米的激光治疗了156个患甲癣的趾甲。治疗后对患者进行了9个月的临床随访，并对病变部位进行了真菌微生物检测。共116份样本分离出了至少一种真菌。大多数指甲超过三分之二的表面受到影响（有些是整个表面）。85%的病例在治疗开始18个月后培养结果转为阴性。3个月后，只有5名患者完全无症状且培养结果为阴性。25名患者在6个月后才无症状且培养结果转阴；29名患者需要9个月。未报告明显的不良反应。这项研究强化了之前的研究成果，表明激光疗法可用于治疗趾甲甲癣。
