{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:20:22Z","timestamp":1792603222518,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,8,12]],"date-time":"2016-08-12T00:00:00Z","timestamp":1470960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,8,12]],"date-time":"2016-08-12T00:00:00Z","timestamp":1470960000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Spanish Academy of Dermatology and Venereology","id":[{"id":"https:\/\/ror.org\/01cp5nb60","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Galderma S.L."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2017,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Onychomycosis is a common fungal nail infection that responds poorly to antifungals.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To investigate the efficacy and safety of methyl aminolevulinate (\n MAL<\/jats:styled-content>\n ) photodynamic therapy (\n PDT<\/jats:styled-content>\n ) in the treatment of onychomycosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A multicentre (3), randomized, placebo\u2010controlled clinical trial compared the effects of three sessions of urea (40%) plus conventional\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n with urea (40%) plus placebo (red light) photodynamic therapy (\n pPDT<\/jats:styled-content>\n ) in onychomycosis patients. Efficacy, both clinical (onychomycosis severity index,\n OSI<\/jats:styled-content>\n ) and microbiological, was blindly evaluated after 36 weeks of follow\u2010up.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty patients were analysed in the trial. Twenty\u2010two received\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n and 18\n pPDT<\/jats:styled-content>\n . A complete response (\n OSI<\/jats:styled-content>\n = 0) was observed for four patients (18.18%) in the\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n group and one (5.56%) in the\n pPDT<\/jats:styled-content>\n group (\n NTT<\/jats:styled-content>\n 7.92, 95%\n CI<\/jats:styled-content>\n : 2.98\u20139.69,\n P<\/jats:italic>\n = 0.23). A decrease in\n OSI<\/jats:styled-content>\n score of over 75% (\n OSI<\/jats:styled-content>\n 75) was achieved by 40.91% of the patients in the\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n group and 16.67% in the\n pPDT<\/jats:styled-content>\n group (\n P<\/jats:italic>\n = 0.096). Microbiological cure was achieved by seven patients (31.82%) in the\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n group and two (11.11%) in the\n pPDT<\/jats:styled-content>\n group (\n P<\/jats:italic>\n = 0.178).\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n resulted in better rates of clinical response [\n OSI<\/jats:styled-content>\n >75%: 53.85% vs. 18.75% (\n P<\/jats:italic>\n =0.048)] and microbiological cure [41.56% vs. 7.14% (\n P<\/jats:italic>\n = 0.037)] in non\u2010dystrophic vs. dystrophic onychomycosis patients. No significant side\u2010effects were reported. The limitations of the study were the reduced sample size and the unexpected efficacy of the control treatment, which was attributed to the 40% urea pre\u2010treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This study did not show significant differences between urea 40% +\n MAL<\/jats:styled-content>\n \u2010\n PDT<\/jats:styled-content>\n and urea 40% +\n pPDT<\/jats:styled-content>\n in the treatment of onychomycosis. However, some results suggest that this treatment may constitute an alternative for dermatophyte and non\u2010dermatophyte mould onychomycosis in patients not eligible for systemic treatment, particularly in the absence of total nail dystrophy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jdv.13842","type":"journal-article","created":{"date-parts":[[2016,8,12]],"date-time":"2016-08-12T04:51:40Z","timestamp":1470977500000},"page":"347-354","source":"Crossref","is-referenced-by-count":53,"title":["Methyl aminolevulinate photodynamic therapy for onychomycosis: a multicentre, randomized, controlled clinical trial"],"prefix":"10.1111","volume":"31","author":[{"given":"Y.","family":"Gilaberte","sequence":"first","affiliation":[{"name":"Department of Dermatology San Jorge Hospital Huesca Spain"},{"name":"Arag\u00f3n Institute of Health Science Zaragoza 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