Efficiency of methylene blue-mediated photodynamic therapy vs intense pulsed light in the treatment of onychomycosis in the toenails
Efficiency of methylene blue-mediated photodynamic therapy vs intense pulsed light in the treatment of onychomycosis in the toenails
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DOI：
10.1111/phpp.12420
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发表时间：
2019-03-01
影响因子：
2.6
通讯作者：
Gomez, Clara
中科院分区：
文献类型：
--
作者：
Alberdi, Enrique;Gomez, Clara
背景光动力疗法(PDT)或强脉冲光疗法(IPL)是治疗浅表皮肤感染的有效方法，是治疗甲真菌病这一最常见的指甲疾病的良好选择。方法将40例不同诊断类型的甲真菌病患者随机分为两组，每组20例。治疗前3~7d，用40%尿素封闭敷料软化甲板12h。然后，应用以亚甲蓝(MB)和红色激光二极管(Periowave(R)，波长=670 nm，200 mW)为中介的PDT方案或基于10 Pulses/cm(2)的IPL方案(Dye-VL-F模块，Alma激光器，波长=500~600 nm，10J)，间隔2周进行8次治疗。结果两种治疗方法均能显著降低甲真菌病严重指数(OSI)(P<；0.05)。完全治愈：治疗12周后，70%的患者达到PDT，80%的患者达到IPL。没有患者报告任何不良反应或并发症，尽管在IPL组中，一些患者在光照射时有痛感和血肿出现。结论光动力疗法和IPL可有效治疗各种病因的甲真菌病。
Background Photodynamic therapy (PDT) or intense pulsed light (IPL) are efficient therapeutic methods in the treatment of superficial skin infections, and thus, they could be good options for onychomycosis treatment, the most common nail disorder. Methods Forty patients, affected with different diagnosed types of onychomycosis in nails of the first toe, were randomly divided into two groups of 20 patients to be treated by PDT or IPL. Nail plates were softened with urea 40% by occlusive dressing for 12 hours during 3-7 days before treatments. Then, eight sessions separated by an interval of 2 weeks of a PDT protocol mediated by methylene blue (MB) and red laser diode (Periowave((R)), lambda = 670 nm, 200 mW) or an IPL protocol based on 10 pulses/cm(2) (Dye-VL-F module, Alma Lasers, lambda = 500-600 nm, 10 J) were applied. Results Both treatments reduced significantly the Onychomycosis Severity Index (OSI) (P < 0.05). In terms of complete cure: 70% (PDT) and 80% (IPL) of the patients reached it after 12 weeks post-treatment. No patient reported any adverse effects or complications, although in the IPL Group, some referred pain sensation during light irradiation and hematomas apparition. Conclusions Photodynamic therapy and IPL were effective for onychomycosis cure of any etiology.