{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:19:28Z","timestamp":1778501968941,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Onychomycosis is a highly prevalent and persistent nail disorder primarily caused by dermatophytes. The effectiveness of current topical and systemic antifungals is limited by the extent and severity of the infection, patient demographics and health status, hepatic toxicity, drug interactions and low compliance. Laser therapy is a promising modality for safe and cost\u2010effective removal of mycotic nail. This prospective study assessed the performance of a multi\u2010series long\u2010pulsed Nd:YAG 1064\u2009nm regimen (30\u201340\u2009J\/cm<jats:sup>2<\/jats:sup>, 1\u2009Hz) in the treatment of 213 mycotic nails in 31 patients. Pain and discomfort were scored at each treatment session and mycological and clinical cure rates were determined 3 months after the last treatment session. Patients presented with mostly severe (mean SCIO score: 21.9\u2009\u00b1\u20098.9), <jats:italic>T. rubrum<\/jats:italic>\u2010positive (87.1%) infections. Most (61%) had a family history of onychomycosis and a significant proportion had comorbidities, including hypertension (38.7%), hyperlipidemia (35.5%) and\/or diabetes (12.9%). Treatment was well tolerated and there were no reports of nail deformity or burns. By 3 months post\u2010treatment, mycological cure was achieved by 4 (12.9%) and visual improvements were noted for 10 (32.3%) patients, including 3 (9.7%) with moderate to significant improvements. Clinical response correlated with baseline SCIO \u2264\u200920 (OR: 0.9 [0.13\u20136.52]), family history of onychomycosis (OR: 0.27 [0.04\u20131.50]) and comorbidities (OR: 0.44 [0.05\u20133.74]). In conclusion, Nd:YAG 1064\u2009nm laser is safe and effective for the management of mild\u2010to\u2010moderate onychomycosis in diverse populations. Further studies will be necessary to adjust treatment parameters to patient and nail profiles and to determine the impact of combined laser and topical therapies.<\/jats:p>","DOI":"10.1111\/myc.13657","type":"journal-article","created":{"date-parts":[[2023,10,21]],"date-time":"2023-10-21T06:39:37Z","timestamp":1697870377000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Nd:<scp>YAG<\/scp> 1064\u2009nm laser treatment for onychomycosis \u2010 is it really effective? A prospective assessment for efficiency and factors contributing to response"],"prefix":"10.1111","volume":"67","author":[{"given":"Batheesh","family":"Ramzy","sequence":"first","affiliation":[{"name":"Department of Dermatology Rambam Health Care Campus  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avitan\u2010Hersh","family":"Emily","sequence":"additional","affiliation":[{"name":"Department of Dermatology Rambam Health Care Campus  Haifa Israel"},{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8045-0682","authenticated-orcid":false,"given":"Badi","family":"Jiryis","sequence":"additional","affiliation":[{"name":"Department of Dermatology Rambam Health Care Campus  Haifa Israel"},{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9586-2807","authenticated-orcid":false,"given":"Khamaysi","family":"Ziad","sequence":"additional","affiliation":[{"name":"Department of Dermatology Rambam Health Care Campus  Haifa Israel"},{"name":"Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa 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