Fractional CO 2 -assisted photodynamic therapy improves the clinical outcome and patient's satisfaction in toenail onychomycosis treatment: an intra-patient comparative single-center study

Device-based therapies have been used for onychomycosis patients with intolerance to systemic treatments. Photodynamic therapy (PDT) improves onychomycosis, while fractional carbon dioxide (FrCO ) augments the topical drug delivery. Comparative studies between PDT alone and laser-assisted one are la...

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Bibliographic Details
Published in:The Journal of dermatological treatment 2022-02, Vol.33 (1), p.542-549
Main Authors: Abdallah, Marwa, Abu-Ghali, Mustafa M, El-Sayed, Mohamed Taha, Soltan, Marwa Y
Format: Article
Language:English
Subjects:
Antifungal Agents - therapeutic use
Carbon Dioxide
Humans
Nails
Onychomycosis - drug therapy
Patient Satisfaction
Personal Satisfaction
Photochemotherapy
Prospective Studies
Treatment Outcome
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Summary:Device-based therapies have been used for onychomycosis patients with intolerance to systemic treatments. Photodynamic therapy (PDT) improves onychomycosis, while fractional carbon dioxide (FrCO ) augments the topical drug delivery. Comparative studies between PDT alone and laser-assisted one are lacking. We aimed to evaluate the efficacy of PDT alone versus FrCO -assisted PDT for treatment of onychomycosis. Twenty-one patients with bilateral onychomycosis of toenails with nearly the same degree of affection were enrolled in this prospective intra-patient-controlled study. The right affected toenail was treated PDT alone. The left toenail was treated a FrCO followed immediately by PDT. The sessions were bimonthly for a total of six sessions. Direct microscopy, fungal cultures, clinical evaluation, onychomycosis severity index scoring, and patient's satisfaction were assessed before and 12 weeks after the last session. Both treatments reduced significantly the onychomycosis severity index (  
ISSN:0954-6634
1471-1753
DOI:10.1080/09546634.2020.1771252