{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:20:44Z","timestamp":1787793644834,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T00:00:00Z","timestamp":1756598400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Onychomycosis, a common fungal nail infection, poses challenges for traditional treatments due to long durations, liver toxicity risks, resistance, and poor nail penetration. So, alternative management approaches, which could involve combination therapy or methods to enhance topical drug delivery for optimal treatment efficacy, should be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      This study evaluates the effectiveness of combining photodynamic therapy (PDT) with fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five patients with onychomycosis were included in the study. Patients were randomly assigned to three groups: PDT alone, fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser alone, and a combination of both. The treatment efficacy was evaluated based on clinical and mycological examinations and patient satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The combined therapy group showed the best results, with 86.7% testing negative for onychomycosis and 26.7% achieving full nail clearance. Posttreatment satisfaction levels showed no significant differences among groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.198).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The combination of PDT and fractional CO\n                      <jats:sub>2<\/jats:sub>\n                      laser appears more effective than either therapy alone, though further research is needed to confirm long\u2010term benefits. Incorporating combined therapy into clinical practice could enhance treatment outcomes for patients with onychomycosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70417","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T06:34:41Z","timestamp":1756708481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessing the Therapeutic Efficacy of Photodynamic Therapy, Fractional\n                    <scp>\n                      CO\n                      <sub>2<\/sub>\n                    <\/scp>\n                    Laser and Its Combination in the Treatment of Onychomycosis"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2442-8728","authenticated-orcid":false,"given":"Hamed","family":"Abdou","sequence":"first","affiliation":[{"name":"Al\u2010Azhar Faculty of Medicine  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Mohsen","sequence":"additional","affiliation":[{"name":"Al\u2010Azhar Faculty of Medicine  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa Taha","family":"Eldestawy","sequence":"additional","affiliation":[{"name":"Al\u2010Azhar Faculty of Medicine  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7616-267X","authenticated-orcid":false,"given":"Shady Mahmoud Attia","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Al\u2010Azhar Faculty of Medicine  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1872213X13666191026090713"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.03.062"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2018.1544891"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2020.101774"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14122738"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdpdt.2020.102090"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.267"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2015.08.005"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12396"},{"issue":"237","key":"e_1_2_12_11_1","first-page":"450","article-title":"Onychomycosis Among Clinically Suspected Cases Attending the Dermatology out\u2010Patient Department of a Tertiary Care Centre: A Descriptive Cross\u2010Sectional Study","volume":"59","author":"Jha B.","year":"2021","journal-title":"JNMA: Journal of the Nepal Medical Association"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504812"},{"issue":"2","key":"e_1_2_12_13_1","first-page":"268","article-title":"The Epidemiology and Etiology of Onychomycosis in 2 Laboratory Centers Affiliated to Tehran University of Medical Sciences During 2019\u20132020","volume":"14","author":"Razavyoon T.","year":"2022","journal-title":"Iran Journal of Microbiology"},{"issue":"10","key":"e_1_2_12_14_1","first-page":"52","article-title":"On the Basis of Sex: Impact and Treatment of Toenail Onychomycosis in Female Patients","volume":"16","author":"Lipner S. 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