Journal of Cosmetic Dermatology

publication_history

received

accepted

published

A New Hope for Melasma: Long-Term Clearance With 755-nm Picosecond Alexandrite Laser and Topical JAK Inhibition.

A New Hope for Melasma: Long‐Term Clearance With 755‐nm Picosecond Alexandrite Laser and Topical JAK Inhibition

Mycoses

<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Antifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug–drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12 months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (<jats:italic>p</jats:italic> = 0.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (<jats:italic>p</jats:italic> &lt; 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Treatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://clinicaltrials.gov">ClinicalTrials.gov</jats:ext-link> identifier: NCT05809297</jats:p></jats:sec>

Oral Antifungal Medication for Toenail Onychomycosis

Cochrane Database of Systematic Reviews

Treatment Options for Onychomycosis: Efficacy, Side Effects, Adherence, Financial Considerations, and Ethics

Journal of Clinical and Aesthetic Dermatology

Efficacy of Laser Therapy in Comparison With Other Methods for the Treatment of Onychomycosis: A Systematic Review and Meta‐Analysis

Cureus

Topical and Device‐Based Treatments for Fungal Infections of the Toenails

Ciclopirox Hydroxypropyl Chitosan: Efficacy in Mild‐To‐Moderate Onychomycosis

Skin Appendage Disorders

Antifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug-drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy.
To evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis.
We conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12 months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH.
The clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (p = 0.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (p < 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.
Treatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH.
ClinicalTrials.gov identifier: NCT05809297.

Diode Laser and Red-Laser Photodynamic Therapy Versus Ciclopirox 8% HPCH Nail Lacquer for the Treatment of Onychomycosis: A Randomised Controlled Trial.

Diode Laser and Red‐Laser Photodynamic Therapy Versus Ciclopirox 8% <scp>HPCH</scp> Nail Lacquer for the Treatment of Onychomycosis: A Randomised Controlled Trial

Journal of Wound Care

<jats:sec><jats:title>Objective:</jats:title><jats:p> Diabetic ulcers are a significant healthcare challenge, capable of diminishing quality of life, lengthening hospitalisation stay, and incurring substantial costs for patients and healthcare systems. Erbium-doped yttrium-aluminum-garnet (Er-YAG) laser has been evolving as a prospective intervention for addressing wounds of various aetiologies. Despite this, the literature remains limited in appraising the effectiveness of laser therapy specifically in diabetic wounds. This study investigates the impact of employing a spatially modulated Er-YAG laser as a therapeutic approach for treating diabetic ulcers. </jats:p></jats:sec><jats:sec><jats:title>Method:</jats:title><jats:p> In a single-arm study conducted from November 2017 to April 2023, patients with hard-to-heal ulcers were treated in a two-step approach of wound debridement using Er-YAG laser for ablation and biostimulation through deep tissue resonance using RecoSMA (Multiline laser system, LINLINE MS, Latvia) laser technology. Ulcers received weekly laser treatment, together with routine care until healing occurred and were then followed up to observe any recurrence. The primary outcome measure was wound closure; the secondary outcome measures were time to closure, and the number of laser treatments required. Data related to sociodemographic details, size and number of diabetic ulcers, and number of sessions related to laser treatment were collected using a predesigned, pretested questionnaire before initiating the treatment. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> A total of 59 patients attending the clinic during the study period with diabetic ulcers were included in the study. The mean wound surface area at baseline was 25.7cm<jats:sup>2</jats:sup> (median: 12cm<jats:sup>2</jats:sup>). The average number of sessions of laser treatment required was 4.41, ranging from 1–11. The size of the ulcer reduced with each session of laser treatment. The diabetic ulcers healed completely at the end of the treatment, indicating the effectiveness of the Er-YAG/RecoSMA two-step approach. </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> Spatially modulated erbium YAG laser is effective as a therapeutic approach for treating diabetic ulcers. </jats:p></jats:sec>

J Diabetes Complications

Curr Res Diabetes Obes J

Foot

Plast Reconstr Surg

Dermatol Clin

Diabetes Care

Indian J Ophthalmol

Ibero-Latin American Plastic Surgery

Phebology

J Vasc Surg

Photobiomodulation, Photomedicine, and Laser Surgery

Novosti Khirurgii

J Wound Care

Diabetic ulcers are a significant healthcare challenge, capable of diminishing quality of life, lengthening hospitalisation stay, and incurring substantial costs for patients and healthcare systems. Erbium-doped yttrium-aluminum-garnet (Er-YAG) laser has been evolving as a prospective intervention for addressing wounds of various aetiologies. Despite this, the literature remains limited in appraising the effectiveness of laser therapy specifically in diabetic wounds. This study investigates the impact of employing a spatially modulated Er-YAG laser as a therapeutic approach for treating diabetic ulcers.
In a single-arm study conducted from November 2017 to April 2023, patients with hard-to-heal ulcers were treated in a two-step approach of wound debridement using Er-YAG laser for ablation and biostimulation through deep tissue resonance using RecoSMA (Multiline laser system, LINLINE MS, Latvia) laser technology. Ulcers received weekly laser treatment, together with routine care until healing occurred and were then followed up to observe any recurrence. The primary outcome measure was wound closure; the secondary outcome measures were time to closure, and the number of laser treatments required. Data related to sociodemographic details, size and number of diabetic ulcers, and number of sessions related to laser treatment were collected using a predesigned, pretested questionnaire before initiating the treatment.
A total of 59 patients attending the clinic during the study period with diabetic ulcers were included in the study. The mean wound surface area at baseline was 25.7cm
Spatially modulated erbium YAG laser is effective as a therapeutic approach for treating diabetic ulcers.

Spatially modulated erbium YAG laser as a treatment for diabetic ulcer.

Spatially modulated erbium YAG laser as a treatment for diabetic ulcer

Papers