Abstract
Onychomycosis is a chronic fungal infection of the finger- and toenails. It is a very common infection that accounts for approximately 50% of all nail pathologies worldwide. This condition is a therapeutic challenge and recently there has been an increase in resistance to current treatment regimes, namely oral and topical antifungal agents. During the last couple of years, laser therapy for the treatment of Onychomycosis has been a topic of discussion as a newer and safer modality of treatment.
The aim of this research was to explore the effectiveness of 1064 nm diode laser therapy for the treatment of Onychomycosis. An exploratory, prospective, quantitative, single-blinded study was conducted on patients with toenail Onychomycosis. Forty-five patients were randomly grouped into three groups and digital images of the toenails were taken to establish the severity of fungal infection. All patients received standard Podiatric treatment before each treatment with laser or control. Nail clippings were taken at the site of infection for PAS staining and fungal microscopy and culture to identify fungal elements and isolate the causative pathogen prior to treatment. Group 1 (control) received 5% topical Amorolfine lacquer to apply to the affected nails once-weekly. Group 2 received 1064 nm diode laser treatment at 10 mW/s wavelength, hallux 790 J/cm2 frequency and lesser digits 390 J/cm2 frequency. Group 3 received 1064 nm laser treatment at 10 mW/s wavelength, hallux 1 100 J/cm2 frequency and lesser digits 500 J/cm2 frequency. These two groups were compared to the control group, and as such, did not receive any topical antifungal therapy. Immediately after each individual laser treatment within each group, nail temperature reached was taken with a surface thermometer, omitting the control group. Specimen diagnostic results indicate that PAS staining was much more sensitive in identifying Onychomycotic infections (91.1%), compared to Fungal Microscopy (44.4%) at week 1. If Fungal Microscopy (and culture) was performed as the only diagnostic test, 55.6%...
M.Tech. (Podiatry)