{"title":"尿素闭塞后单次点阵 CO2 激光治疗甲癣:试点研究","authors":"Eeshaan Ranjan, Sandeep Arora, Ajay Shanker Sharma, Neha Sharma, Rajeshwari Dabas","doi":"10.1159/000527252","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO<sub>2</sub> (FCO<sub>2</sub>) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO<sub>2</sub> laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO<sub>2</sub> laser with 1% terbinafine cream with and without \"urea cream occlusion\" in managing onychomycosis.</p><p><strong>Methods: </strong>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 FCO<sub>2</sub> 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.</p><p><strong>Results: </strong>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 (<i>p</i> < 0.05) only in group A.</p><p><strong>Conclusion: </strong>Single-session FCO<sub>2</sub> laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":"9 4","pages":"268-274"},"PeriodicalIF":1.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410086/pdf/","citationCount":"0","resultStr":"{\"title\":\"Single-Session Fractional CO<sub>2</sub> Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study.\",\"authors\":\"Eeshaan Ranjan, Sandeep Arora, Ajay Shanker Sharma, Neha Sharma, Rajeshwari Dabas\",\"doi\":\"10.1159/000527252\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO<sub>2</sub> (FCO<sub>2</sub>) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO<sub>2</sub> laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO<sub>2</sub> laser with 1% terbinafine cream with and without \\\"urea cream occlusion\\\" in managing onychomycosis.</p><p><strong>Methods: </strong>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 FCO<sub>2</sub> 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.</p><p><strong>Results: </strong>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 (<i>p</i> < 0.05) only in group A.</p><p><strong>Conclusion: </strong>Single-session FCO<sub>2</sub> laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.</p>\",\"PeriodicalId\":21844,\"journal\":{\"name\":\"Skin Appendage Disorders\",\"volume\":\"9 4\",\"pages\":\"268-274\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410086/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Skin Appendage Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000527252\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skin Appendage Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000527252","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
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.