尿素闭塞后单次点阵 CO2 激光治疗甲癣:试点研究

IF 1.4 Q3 DERMATOLOGY Skin Appendage Disorders Pub Date : 2023-08-01 Epub Date: 2023-04-14 DOI:10.1159/000527252
Eeshaan Ranjan, Sandeep Arora, Ajay Shanker Sharma, Neha Sharma, Rajeshwari Dabas
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引用次数: 0

摘要

简介甲癣是一种常见的指甲疾病。抗真菌药物的耐药性、相互作用和副作用限制了治疗方案的选择。点阵 CO2(FCO2)激光配合外用抗真菌剂每月多次治疗有效。减少重复就诊次数、提高依从性的治疗方法更为可取。据报道,在尿素闭塞后进行单次 FCO2 激光治疗是有效的。因此,我们进行了一项研究,以确定单次 FCO2 激光与 1%特比萘芬乳膏同时使用或不使用 "尿素乳膏闭塞 "治疗甲癣的疗效:在一家三级医疗中心进行了一项前瞻性、随机、平行组研究。通过真菌装片和培养阳性确认为股癣。患者被随机分为两组,接受单次 FCO2 激光治疗。A 组在隔夜尿素霜封闭后进行治疗,B 组不进行封闭。两组均使用 1%特比萘芬乳膏,每天两次,持续 3 个月。根据 6 个月后甲真菌病严重程度指数(OSI)的改善情况来评估疗效:结果:A 组有 10 名患者,14 个指甲。12/14(85.7%)趾甲的临床症状有所改善。OSI 平均下降了 10.78。B 组有 10 名患者,11 枚指甲。5/11(45.5%)名患者的指甲临床症状有所改善。OSI 平均减少了 1.73。只有 A 组的 "OSI 减少 "具有统计学意义(P < 0.05):结论:在隔夜尿素软膏封闭后使用 1%特比萘芬软膏进行单次 FCO2 激光治疗对治疗甲癣有效。
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Single-Session Fractional CO2 Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study.

Introduction: Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO2 (FCO2) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO2 laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO2 laser with 1% terbinafine cream with and without "urea cream occlusion" in managing onychomycosis.

Methods: A prospective, randomized, parallel-group study was conducted at a tertiary centre. Onychomycosis was confirmed by positive fungal mount and culture. Patients were randomized into 2 groups and administered single-session FCO2 laser. Group A was treated after overnight urea cream occlusion and group B without occlusion. Both groups applied 1% terbinafine cream twice daily for 3 months. Response was assessed by improvement in Onychomycosis Severity Index (OSI) at 6 months.

Results: Group A had 10 patients, 14 nails. Clinical improvement was seen in 12/14 (85.7%) nails. Average reduction in OSI was 10.78. Group B had 10 patients, 11 nails. Clinical improvement was seen in 5/11 (45.5%) nails. Average reduction in OSI was 1.73. "Reduction in OSI" was statistically significant (p < 0.05) only in group A.

Conclusion: Single-session FCO2 laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.

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