레이저와 광치료를 이용한 손발톱진균증의 치료
Laser and Light Sources in the Treatment of Onychomycosis
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Onychomycosis is a common fungal infection of the nails and there is wide distribution across the continent. Aside from Trichophyton rubrum (88%) being the main causative agent, other dermatophytes, yeasts or non-dermatophyte molds can affect nails and adjacent tissues and cause sundry symptoms: subungual hyperkeratosis, onycholysis, nail thickening, discoloration, malodorous condition. Oral antifungal agents are the mainstay treatment for onychomycosis but undesirable side effects, such as hepatotoxicity, remain a main reason for drug withdrawal. Moreover, other modalities as a reliable treatment option are disappointing with a low cure rate. The advancement in laser and light technology has opened a new field of opportunity for the treatment of refractory skin disease. As supported in clinical studies, neodymium-doped yttrium aluminium garnet laser, diode laser, fractional carbon dioxide laser, and erbium:glass laser have produced a favorable outcome, with or without additional agents, for the treatment of onychomycosis. But the mechanism is still unclear and reliable data are relatively scarce despite the potential as an alternative armamentarium. To date, as with laser therapy, there have been only a few studies conducted concerning the role of light therapy in the superficial fungal infection. Herein we aimed to review the medical literature on laser and light therapy of onychomycosis and provide our point of view for health providers and researchers.
Abstract
Onychomycosis is a common fungal infection of the nails and there is wide distribution across the continent. Aside from Trichophyton rubrum (88%) being the main causative agent, other dermatophytes, yeasts or non-dermatophyte molds can affect nails and adjacent tissues and cause sundry symptoms: subungual hyperkeratosis, onycholysis, nail thickening, discoloration, malodorous condition. Oral antifungal agents are the mainstay treatment for onychomycosis but undesirable side effects, such as hepatotoxicity, remain a main reason for drug withdrawal. Moreover, other modalities as a reliable treatment option are disappointing with a low cure rate. The advancement in laser and light technology has opened a new field of opportunity for the treatment of refractory skin disease. As supported in clinical studies, neodymium-doped yttrium aluminium garnet laser, diode laser, fractional carbon dioxide laser, and erbium:glass laser have produced a favorable outcome, with or without additional agents, for the treatment of onychomycosis. But the mechanism is still unclear and reliable data are relatively scarce despite the potential as an alternative armamentarium. To date, as with laser therapy, there have been only a few studies conducted concerning the role of light therapy in the superficial fungal infection. Herein we aimed to review the medical literature on laser and light therapy of onychomycosis and provide our point of view for health providers and researchers.
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