BACKGROUND@#
Laser therapy can be used as an alternative
treatment for
onychomycosis ; however, there are somelimitations to its
efficacy as a single agent.@*OBJECTIVE@#To evaluate the
effectiveness of combination
therapy with 1,064-nm
neodymium -doped
yttrium aluminum garnet (NdYAG)
laser and topical efinaconazole in
onychomycosis treatment and identify factors influencing the
therapeutic outcomes of combination
treatment .@*
METHODS @#Big
toenails with
onychomycosis were treated by 1,064-nm NdYAG laser at 4-week intervals with daily application of topical efinaconazole.
Therapeutic response was assessed through
onychomycosis severity index (OSI) and percentage of
nail infected (PNI), and its
association with a variety of factors that may
affect treatment outcome was evaluated.@*RESULTS@#One hundred big
toenails were included in the study and significant clinical improvements were observed
after treatment (OSI improvement score = 76.68 ± 28.83, PNI improvement score = 72.37 ± 30.37). There was no difference in
treatment response according to the number of
laser treatments ,
onychomycosis clinical type, or initial severity. However,
patient age was negatively correlated with clinical improvement (p = 0.019). Also,
female patients had better
therapeutic responses than
male patients .@*CONCLUSION@#Combined
treatment with NdYAG laser and topical efinaconazole has a significant
therapeutic effect on
onychomycosis . A
randomized controlled trial is warranted in the
future .