BACKGROUND
Onychomycosis is an infectious disease of the nail plates caused by fungi. In recent years, there has been an increase in the number of patients with onychomycosis, as well as resistance to traditional antifungal agents, therefore the development of alternative treatment methods is becoming urgent. Laser and photodynamic therapies are such methods.
OBJECTIVE
To compare the efficacy of two treatment phototherapeutic methods of the feet onychomycosis: laser and photodynamic therapies.
MATERIAL AND METHODS
An open, comparative, prospective study involved 32 patients (18 women and 14 men) aged 21—60 years with distal lateral onychomycosis of the feet. Patients were divided into 2 groups: 12 patients received treatment with Nd:YAG-laser (1064 nm) in the 1st group, 20 patients underwent photodynamic therapy using a gel containing the chlorin e6 derivative as a photosensitiser in the 2nd group. The course of treatment included 8 procedures, the duration of therapy was 3 months. In addition, all patients underwent hardware cleaning of the nail plates and were administered with topical external antimycotics. The efficacy of the therapy was clinically evaluated by the rate of a healthy nail plate growth, as well as by microscopic examination of pathogenic fungi on the 12th and 24th weeks of treatment.
RESULTS
Mycological and clinical recovery has been achieved only in 1 (8%) patient in the group of subjects treated with laser. Photodynamic therapy has shown a high efficacy: mycological and clinical recovery was observed in 12 (60%) patients, a significant improvement — in 5 (25%) on the 24th week. The mean SCIO index value in the 2nd group decreased from 8.8 at the beginning of the study to 4.2 at the 24th week of treatment.
CONCLUSION
The photodynamic therapy using a chlorine-containing photosensitizer exceedes the treatment with Nd:YAG-laser (1064 nm) on the efficacy and is a promising method of treatment of distal lateral onychomycosis.
