Single-Session Fractional CO2 Laser following Urea Occlusion in Management of Onychomycosis: A Pilot Study

Novel Treatments - Research Article

Ranjan E.Arora S.b· Sharma A.S.c· Sharma N.d· Dabas R.e

Author affiliations

aDepartment of Dermatology, Military Hospital, Jammu, India
bDepartment of Dermatology, Base Hospital, Delhi, India
cDepartment of Pathology, Military Hospital, Jammu, India
dDepartment of Public Health, PGIMER, Chandigarh, India
eDepartment of Dermatology Command Hospital, Udhampur, India

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Article / Publication Details

Received: July 30, 2022
Accepted: September 22, 2022
Published online: April 14, 2023

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 3

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: Onychomycosis is a common nail disorders. Antifungal resistance, interactions, and side effects limit treatment options. Fractional CO2 (FCO2) laser along with topical antifungal is effective in multiple monthly sessions. A modification reducing repeated visits and hence better compliance is preferable. Single-session FCO2 laser following urea occlusion is reported to be effective. Thus, we conducted a study to determine the efficacy of single-session FCO2 laser with 1% terbinafine cream with and without “urea cream occlusion” in managing onychomycosis. Methods: A prospective, randomized, parallel-group study was conducted at a tertiary centre. Onychomycosis was confirmed by positive fungal mount and culture. Patients were randomized into 2 groups and administered single-session FCO2 laser. Group A was treated after overnight urea cream occlusion and group B without occlusion. Both groups applied 1% terbinafine cream twice daily for 3 months. Response was assessed by improvement in Onychomycosis Severity Index (OSI) at 6 months. Results: Group A had 10 patients, 14 nails. Clinical improvement was seen in 12/14 (85.7%) nails. Average reduction in OSI was 10.78. Group B had 10 patients, 11 nails. Clinical improvement was seen in 5/11 (45.5%) nails. Average reduction in OSI was 1.73. “Reduction in OSI” was statistically significant (p < 0.05) only in group A. Conclusion: Single-session FCO2 laser following overnight urea cream occlusion, followed by 1% terbinafine cream, is effective for management of onychomycosis.

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Received: July 30, 2022
Accepted: September 22, 2022
Published online: April 14, 2023

Number of Print Pages: 7
Number of Figures: 5
Number of Tables: 3

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

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