Alberdi Enrique, Gómez Clara
Consulta privada Enrique Alberdi, Madrid, Spain.
Instituto de Química Física Rocasolano, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain.
Photodermatol Photoimmunol Photomed. 2019 Mar;35(2):69-77. doi: 10.1111/phpp.12420. Epub 2018 Sep 17.
Photodynamic therapy (PDT) or intense pulsed light (IPL) are efficient therapeutic methods in the treatment of superficial skin infections, and thus, they could be good options for onychomycosis treatment, the most common nail disorder.
Forty patients, affected with different diagnosed types of onychomycosis in nails of the first toe, were randomly divided into two groups of 20 patients to be treated by PDT or IPL. Nail plates were softened with urea 40% by occlusive dressing for 12 hours during 3-7 days before treatments. Then, eight sessions separated by an interval of 2 weeks of a PDT protocol mediated by methylene blue (MB) and red laser diode (Periowave , λ = 670 nm, 200 mW) or an IPL protocol based on 10 pulses/cm (Dye-VL-F module, Alma Lasers, λ = 500-600 nm, 10 J) were applied.
Both treatments reduced significantly the Onychomycosis Severity Index (OSI) (P < 0.05). In terms of complete cure: 70% (PDT) and 80% (IPL) of the patients reached it after 12 weeks post-treatment. No patient reported any adverse effects or complications, although in the IPL Group, some referred pain sensation during light irradiation and hematomas apparition.
Photodynamic therapy and IPL were effective for onychomycosis cure of any etiology.
光动力疗法（PDT）或强脉冲光（IPL）是治疗浅表皮肤感染的有效方法，因此，它们可能是治疗甲癣（最常见的指甲疾病）的良好选择。
40例第一趾甲患有不同诊断类型甲癣的患者被随机分为两组，每组20例，分别接受PDT或IPL治疗。在治疗前3至7天，用40%尿素封闭敷料软化甲板12小时。然后，应用由亚甲蓝（MB）和红色激光二极管（Periowave，λ = 670 nm，200 mW）介导的PDT方案或基于10脉冲/厘米（Dye-VL-F模块，Alma Lasers，λ = 500 - 600 nm，10 J）的IPL方案，每隔2周进行8次治疗。
两种治疗方法均显著降低了甲癣严重程度指数（OSI）（P < 0.05）。就完全治愈而言：70%（PDT）和80%（IPL）的患者在治疗后12周达到完全治愈。没有患者报告任何不良反应或并发症，尽管在IPL组中，一些患者在光照期间感到疼痛，并且出现了血肿。
光动力疗法和IPL对任何病因引起的甲癣治疗均有效。
