Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up

Background: Onychomycosis is a common nail infection primarily caused by Trichophyton rubrum, posing therapeutic challenges due to poor antifungal penetration and high recurrence rates. Conventional treatments include topical and systemic antifungals, but novel approaches such as laser therapy and c...

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Autores: García de la Peña, Raquel, Juárez Jiménez, José María, Martiniano, J.M.C, Pérez, A.M.R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:dnet:idus________::6d701565a20d42adb2084287542d0da3
Acceso en línea:https://hdl.handle.net/11441/187189
https://doi.org/10.3390/idr18010001
Access Level:acceso abierto
Palabra clave:Onychomycosis
Trichophyton rubrum
Nd:YAG laser
Nitric acid
Combination therapy
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spelling Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-UpGarcía de la Peña, RaquelJuárez Jiménez, José MaríaMartiniano, J.M.CPérez, A.M.ROnychomycosisTrichophyton rubrumNd:YAG laserNitric acidCombination therapyBackground: Onychomycosis is a common nail infection primarily caused by Trichophyton rubrum, posing therapeutic challenges due to poor antifungal penetration and high recurrence rates. Conventional treatments include topical and systemic antifungals, but novel approaches such as laser therapy and chemical agents like nitric acid have emerged as promising alternatives or adjuncts. However, comparative evidence regarding the clinical and mycological efficacy of these treatments remains limited. Objectives: We aimed to assess and compare the clinical and mycological efficacy of three therapeutic modalities—69% nitric acid, 1064 nm Nd:YAG laser, and their combination—in the treatment of Trichophyton rubrum onychomycosis over a 12-month follow-up period. Methods: A prospective, comparative, observational study was conducted, assigning patients with confirmed onychomycosis to one of three treatment groups: nitric acid, Nd:YAG 1064 nm laser, or combination therapy. Clinical and mycological cure rates, mean time to clinical resolution, changes in Onychomycosis Severity Index [OSI] scores, and mycological relapse rates were assessed over a 12-month follow-up. Results: All three groups demonstrated significant improvement in both clinical and mycological cure rates, with the combination therapy yielding the most favorable outcomes in terms of response speed and durability. Laser and nitric acid monotherapies were also effective, though associated with lower cure rates and longer times to resolution. The relapse rate was lowest in the combination group. Conclusions: The combination of nitric acid and Nd:YAG laser appears to be a more effective therapeutic option for Trichophyton rubrum onychomycosis, offering superior clinical and mycological outcomes compared to monotherapies, with faster resolution and lower relapse rates. These findings suggest that combination therapy may optimize the management of this challenging nail infection.MDPIPodologíaCTS589: Avances en Cirugía Podológica2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/187189https://doi.org/10.3390/idr18010001reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésInfectious disease reports, 18 (1), 1. https://www.mdpi.com/2036-7449/18/1/1info:eu-repo/semantics/openAccessoai:dnet:idus________::6d701565a20d42adb2084287542d0da32026-06-17T12:51:07Z
dc.title.none.fl_str_mv Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
title Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
spellingShingle Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
García de la Peña, Raquel
Onychomycosis
Trichophyton rubrum
Nd:YAG laser
Nitric acid
Combination therapy
title_short Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
title_full Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
title_fullStr Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
title_full_unstemmed Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
title_sort Comparative Retrospective Evaluation of the Clinical and Mycological Efficacy of 69% Nitric Acid, 1064 nm Nd:YAG Laser, and Their Combination in the Treatment of Trichophyton rubrum Onychomycosis over a 12-Month Follow-Up
dc.creator.none.fl_str_mv García de la Peña, Raquel
Juárez Jiménez, José María
Martiniano, J.M.C
Pérez, A.M.R
author García de la Peña, Raquel
author_facet García de la Peña, Raquel
Juárez Jiménez, José María
Martiniano, J.M.C
Pérez, A.M.R
author_role author
author2 Juárez Jiménez, José María
Martiniano, J.M.C
Pérez, A.M.R
author2_role author
author
author
dc.contributor.none.fl_str_mv Podología
CTS589: Avances en Cirugía Podológica
dc.subject.none.fl_str_mv Onychomycosis
Trichophyton rubrum
Nd:YAG laser
Nitric acid
Combination therapy
topic Onychomycosis
Trichophyton rubrum
Nd:YAG laser
Nitric acid
Combination therapy
description Background: Onychomycosis is a common nail infection primarily caused by Trichophyton rubrum, posing therapeutic challenges due to poor antifungal penetration and high recurrence rates. Conventional treatments include topical and systemic antifungals, but novel approaches such as laser therapy and chemical agents like nitric acid have emerged as promising alternatives or adjuncts. However, comparative evidence regarding the clinical and mycological efficacy of these treatments remains limited. Objectives: We aimed to assess and compare the clinical and mycological efficacy of three therapeutic modalities—69% nitric acid, 1064 nm Nd:YAG laser, and their combination—in the treatment of Trichophyton rubrum onychomycosis over a 12-month follow-up period. Methods: A prospective, comparative, observational study was conducted, assigning patients with confirmed onychomycosis to one of three treatment groups: nitric acid, Nd:YAG 1064 nm laser, or combination therapy. Clinical and mycological cure rates, mean time to clinical resolution, changes in Onychomycosis Severity Index [OSI] scores, and mycological relapse rates were assessed over a 12-month follow-up. Results: All three groups demonstrated significant improvement in both clinical and mycological cure rates, with the combination therapy yielding the most favorable outcomes in terms of response speed and durability. Laser and nitric acid monotherapies were also effective, though associated with lower cure rates and longer times to resolution. The relapse rate was lowest in the combination group. Conclusions: The combination of nitric acid and Nd:YAG laser appears to be a more effective therapeutic option for Trichophyton rubrum onychomycosis, offering superior clinical and mycological outcomes compared to monotherapies, with faster resolution and lower relapse rates. These findings suggest that combination therapy may optimize the management of this challenging nail infection.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/187189
https://doi.org/10.3390/idr18010001
url https://hdl.handle.net/11441/187189
https://doi.org/10.3390/idr18010001
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Infectious disease reports, 18 (1), 1.
https://www.mdpi.com/2036-7449/18/1/1
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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