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评估光动力疗法、分次二氧化碳激光及其联合应用治疗甲癣的疗效。

Assessing the Therapeutic Efficacy of Photodynamic Therapy, Fractional CO Laser and Its Combination in the Treatment of Onychomycosis.

作者信息

Abdou Hamed, Mohsen Muhammad, Eldestawy Mostafa Taha, Ibrahim Shady Mahmoud Attia

机构信息

Al-Azhar Faculty of Medicine, Cairo, Egypt.

出版信息

J Cosmet Dermatol. 2025 Sep;24(9):e70417. doi: 10.1111/jocd.70417.

Abstract

BACKGROUND

Onychomycosis, a common fungal nail infection, poses challenges for traditional treatments due to long durations, liver toxicity risks, resistance, and poor nail penetration. So, alternative management approaches, which could involve combination therapy or methods to enhance topical drug delivery for optimal treatment efficacy, should be considered.

AIMS

This study evaluates the effectiveness of combining photodynamic therapy (PDT) with fractional CO laser treatment.

PATIENTS/METHODS: Forty-five patients with onychomycosis were included in the study. Patients were randomly assigned to three groups: PDT alone, fractional CO laser alone, and a combination of both. The treatment efficacy was evaluated based on clinical and mycological examinations and patient satisfaction.

RESULTS

The combined therapy group showed the best results, with 86.7% testing negative for onychomycosis and 26.7% achieving full nail clearance. Posttreatment satisfaction levels showed no significant differences among groups (p = 0.198).

CONCLUSION

The combination of PDT and fractional CO laser appears more effective than either therapy alone, though further research is needed to confirm long-term benefits. Incorporating combined therapy into clinical practice could enhance treatment outcomes for patients with onychomycosis.

摘要

背景

甲癣是一种常见的指甲真菌感染,由于治疗时间长、存在肝毒性风险、耐药性以及药物对指甲的渗透性差等问题,给传统治疗带来了挑战。因此,应考虑采用替代管理方法,这可能包括联合治疗或增强局部药物递送以实现最佳治疗效果的方法。

目的

本研究评估光动力疗法(PDT)与分数CO2激光治疗联合应用的有效性。

患者/方法:45例甲癣患者纳入本研究。患者被随机分为三组:单纯PDT组、单纯分数CO2激光组和两者联合组。基于临床和真菌学检查以及患者满意度评估治疗效果。

结果

联合治疗组显示出最佳效果,86.7%的患者甲癣检测呈阴性,26.7%的患者指甲完全清除。治疗后各组满意度水平无显著差异(p = 0.198)。

结论

PDT与分数CO2激光联合应用似乎比单独使用任何一种疗法更有效,不过需要进一步研究以证实长期益处。将联合治疗纳入临床实践可提高甲癣患者的治疗效果。

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