Lee Yun Ho, Lee Heun Joo, Kim Won-Serk, Lee Ga-Young, Choi Young-Jun
Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Cosmet Dermatol. 2021 Feb;20(2):497-505. doi: 10.1111/jocd.13580. Epub 2020 Jul 21.
Laser treatment has emerged as a novel treatment modality for onychodystrophy. Only a few small series have assessed the efficacy of laser treatment in onychodystrophy, most of which were case reports. The therapeutic effect of the 1064 nm neodymium-doped:yttrium aluminum garnet (Nd:YAG) laser for onychodystrophy has been demonstrated. Recently, the picosecond Nd:YAG (PSNY) laser has been introduced to improve various skin disorders.
The aim of this study was to verify the efficacy of a 1064 nm PSNY in management of idiopathic onychodystrophy.
We present a case series of dystrophic nails treated with a PSNY for onychodystrophy improvement. Planimetry using ImageJ software was used to calculate lesion reduction and proximal clear nail growth. Clinical improvement was assessed using a 5-point Global Assessment Scale (GAS). Adverse events were also assessed.
Twenty-five patients (11 males and 14 females) with a total of 128 nails (94 finger nails and 34 toe nails) were treated. The mean treatment number was 8.7 ± 6.2, and the mean total duration of treatment was 33.4 ± 34.6 weeks. The average proportion of the lesion area decreased significantly (from 65.9% to 46.6%) after PSNY treatment (P < .001). The mean GAS (3.16 ± 1.18) exhibited fair improvement, and there were no serious adverse events.
The 1064 nm PSNY laser can provide fair improvement for onychodystrophy with a good prognosis at least during the follow-up period and optimal cosmetic results in Asian patients.
激光治疗已成为一种用于甲营养不良的新型治疗方式。仅有少数小样本研究评估了激光治疗甲营养不良的疗效,其中大多数为病例报告。已证实1064纳米掺钕钇铝石榴石(Nd:YAG)激光对甲营养不良有治疗效果。最近,皮秒Nd:YAG(PSNY)激光已被用于改善各种皮肤疾病。
本研究的目的是验证1064纳米PSNY激光治疗特发性甲营养不良的疗效。
我们展示了一组用PSNY激光治疗以改善甲营养不良的营养不良性指甲病例系列。使用ImageJ软件进行面积测量以计算病损缩小情况和近端正常甲生长情况。使用5分制整体评估量表(GAS)评估临床改善情况。同时也评估了不良事件。
共治疗了25例患者(11例男性和14例女性),总计128枚指甲(94枚手指甲和34枚脚趾甲)。平均治疗次数为8.7±6.2次,平均总治疗时长为33.4±34.6周。PSNY激光治疗后病损面积的平均比例显著下降(从65.9%降至46.6%)(P<.001)。平均GAS评分为3.16±1.18,显示出较好的改善,且未出现严重不良事件。
1064纳米PSNY激光至少在随访期内可为甲营养不良提供较好的改善效果,预后良好,且在亚洲患者中可获得最佳的美容效果。