Pruangmethangkul Thunyaporn, Pongprutthipan Marisa, Chottawornsak Natcha, Kerr Stephen J, Rerknimitr Pawinee
Division of Dermatology, Department of Medicine, Faculty of Medicine, Center of Excellence for Skin and Allergy Research, Chulalongkorn University, Bangkok, Thailand.
Center for Excellence in Biostatistics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Lasers Surg Med. 2025 Nov;57(9):691-699. doi: 10.1002/lsm.70060. Epub 2025 Aug 30.
Paronychia is a common side effect of anticancer therapies, particularly epidermal growth factor receptor inhibitors (EGFRIs). Standard treatments often provide limited relief. Pulsed dye laser (PDL) therapy at 595 nm, with vascular-targeting and anti-inflammatory effects, may serve as an effective adjunctive treatment.
To evaluate the clinical efficacy and safety of adjunctive 595-nm PDL therapy in the treatment of paronychia induced by anticancer drugs, particularly EGFRIs.
This prospective pre-post study included 70 digits with anticancer drug-induced paronychia, Common Terminology Criteria for Adverse Events [CTCAE] grade 1-2, from ten patients. After a 2-week run-in with standardized treatment, participants received 4 weekly sessions of 595-nm PDL therapy. Outcomes-assessed at baseline, each visit, and 2 weeks posttreatment-included erythema index (EI), modified Severity of Paronychia Assessment Tool (SPOT) score, pain, edema, Physician Global Assessment (PGA), patient satisfaction, and adverse events.
PDL therapy significantly reduced the EI from 1.63 to 1.42 (p < 0.001) and edema from 1.67 to 1.45 (p < 0.001). Modified SPOT scores improved from 3.61 to 1.99 (p < 0.001), with early pain relief observed (4.40-1.25; p < 0.001). PGA improved by Week 3, and patient satisfaction increased from 0 to 100 by Week 5 (p < 0.001).
PDL adjuvant therapy significantly improves both clinical signs and patient-reported outcomes in anticancer drug-induced paronychia.
甲沟炎是抗癌治疗的常见副作用，尤其是表皮生长因子受体抑制剂（EGFRIs）。标准治疗往往效果有限。595nm的脉冲染料激光（PDL）疗法具有血管靶向和抗炎作用，可能是一种有效的辅助治疗方法。
评估辅助性595nm PDL疗法治疗抗癌药物尤其是EGFRIs所致甲沟炎的临床疗效和安全性。
这项前瞻性前后对照研究纳入了10例患者的70个因抗癌药物引起的甲沟炎手指，不良事件通用术语标准（CTCAE）分级为1-2级。在进行2周标准化治疗的导入期后，参与者接受4次每周一次的595nm PDL治疗。在基线、每次就诊时以及治疗后2周评估的结果包括红斑指数（EI）、改良甲沟炎评估工具（SPOT）评分、疼痛、水肿、医生整体评估（PGA）、患者满意度和不良事件。
PDL治疗使EI从1.63显著降低至1.42（p<0.001），水肿从1.67降至1.45（p<0.001）。改良SPOT评分从3.61提高到1.99（p<0.001），早期疼痛缓解明显（4.40-1.25；p<0.001）。PGA在第3周有所改善，患者满意度在第5周从0提高到100（p<0.001）。
PDL辅助治疗可显著改善抗癌药物所致甲沟炎的临床体征和患者报告的结果。
