Combining 8 sessions of diode laser therapy and 3 sessions of red-laser PDT with toluidine blue gel is safe and efficient to relieve mild, moderate, and severe fungal infection of the nails.
A new case series reported a 100% cure rate in treating mild-to-severe onychomycosis—a common and difficult-to-treat nail fungal infection—using a combination of diode laser therapy and red-laser photodynamic therapy (PDT) with toluidine blue gel.
In this study, 12 patients with a total of 17 infected nails were treated over a 6-month period. The treatment protocol included 8 diode laser sessions and 3 sessions of red-laser PDT, each combined with the application of toluidine blue gel, a photosensitizing agent that helps target fungal organisms when activated by specific wavelengths of light. Clinical cure—defined as the visible clearance of infection—was evaluated 1 week after completing the treatment.
Mycological cure, indicating the absence of fungal organisms, was confirmed through microbiological culture. Results were promising! After treatment, all the participants achieved 100% clinical, mycological, and complete cure rates. While the intervention was generally well-tolerated, some side effects were noted. All patients reported experiencing pain during the laser sessions, and 2 individuals developed post-treatment complications, including subungual blistering and hematomas.
However, no adverse reactions occurred during or after the PDT sessions. Follow-up over 6 months revealed that 2 patients (16.7%) experienced recurrence in 3 nails (17.6%), suggesting that while the initial cure rate is high, the potential for relapse remains and may warrant maintenance therapy or longer-term follow-up.
Microbiology Research
Diode Laser and Red-Laser Photodynamic Therapy with Toluidine Blue Gel for the Treatment of Onychomycosis: A Case Series
García-Oreja S et al.
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