Original articleTreatment of onychomycosis using a submillisecond 1064-nm neodymium:yttrium-aluminum-garnet laser
Section snippets
In vitro
Three common, but unrelated, nail pathogens were used for the in vitro portion of the study. Trichophyton rubrum, Epidermophyton floccosum, and Scytalidium dimidiatum were grown on agar slants. S hyalinum was selected as a representative nondermatophyte mold. Fungal elements were teased off the colony into sterile water to make a suspension of 0.4 × 104 to 5 × 104 colony-forming unit (CFU)/mL. Each fungal suspension was placed into 8 0.2-mL polymerase chain reaction tubes. The tubes were then
Thermal treatment results
Control plates began to show confluent growth after 4 days of incubation. Reduction in the growth of T rubrum was seen at temperatures of 50°C, held for at least 5 minutes. A fungicidal effect was seen at 50°C with exposure times of 15 minutes. E floccosum showed significantly reduced CFU counts when held at 50°C for 2 minutes and a fungicidal effect was seen at 50°C with exposure times of 10 minutes. S dimidiatum showed confluent growth at every time-temperature treatment except for 55°C for 5
Discussion
Previous in vitro work by Vural et al2 showed statistically significant growth inhibition of T rubrum colonies treated with both the Nd:YAG 1064-nm and 532-nm lasers, supporting laser as a treatment for onychomycosis. The 1064-nm effectiveness was postulated to be a result of photothermolysis caused by absorption of laser light by the melanin found in the cell wall of T rubrum. Photoinactivation of T rubrum was also reported by Bornstein et al3 after irradiation with a combined 870- and 930-nm
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Onychomycosis: Treatment and prevention of recurrence
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Supported by Cutera Inc, Brisbane, CA.
Disclosure: Dr Elewski has received grants from Cutera Inc and Anacor Pharmaceuticals Inc, and a grant and honoraria from Valeant Pharmaceuticals International Inc. Drs Carney and Cantrell and Ms Warner have no conflicts of interest to declare.