USE OF THE 1064NM - 532NM Q-SWITCHED ND-YAG LASER IN THE TREATMENT OF ONYCHOMYCOSIS PEDIS

Abstract

Onychomycosis is the most common fungal infection of the nail, may affect both toenails or fingernails. Clinical symptoms included thickened and discoloured nail or chromonyquia, progressive brittle, white or yellow patches on the nailbed. Common pathogens are dermathophytes, Candida (yeast) and no dermatophytes molds. Risk factors are aging, hyperhidrosis , psoriasis, socks and shoes that hinder ventilationg and do not absorb perspiration, going barefoot in damp public places, tinea pedis, minor skin or nail injuries, diabetes, vascular problems, weakened immune system. Laboratory confirmation, potassium hydroxide smear, culture and histology, microscopic examination and culture of nail scrapings or clippings,or both combine,are neccesary for diagnosis. Antifungal medications and topical treatments do not appear to improve outcome.Oral therapy for long periods has systemic side effects. The aim of this study was to treat a clinical proved onychomycosis and observe the results. We treat a female patient with clinical diagnosis of Onychomycosis that received in the past oral and topical therapy without results. Was given 4 sessions with one week interval, 1064-nm and 532-nm Nd:YAG Q-switched. We found nail lightening and thinning that improved the aesthetic appearance. Laser treatment appear tobe a reliable aesthetic alternative in onychomycosis, since there is not compliant with FDA cure requirements. Fungal sensitivity to heat disrupt growth, development and reproduction. Nd:YAG 1064-nm and 532-nm can penetrate as deep as the lower nail plate targeting fungal structures without significant complications or side effects. Laser is expected to become an alternative or replacement therapy for onychomycosis that can improve the aesthetic appearance of the nails.