{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:13:42Z","timestamp":1787681622074,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"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":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug\u2013drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12\u2009months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6\u2009\u00b1\u20091.2\u2009months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2\u2009\u00b1\u20091.6\u2009months) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Treatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT05809297\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70121","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T07:39:48Z","timestamp":1759217988000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diode Laser and Red\u2010Laser Photodynamic Therapy Versus Ciclopirox 8%\n                    <scp>HPCH<\/scp>\n                    Nail Lacquer for the Treatment of Onychomycosis: A Randomised Controlled Trial"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-7122","authenticated-orcid":false,"given":"Sara","family":"Garc\u00eda\u2010Oreja","sequence":"first","affiliation":[{"name":"University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry Complutense University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-3822","authenticated-orcid":false,"given":"Francisco Javier","family":"\u00c1lvaro\u2010Afonso","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid Health Research Institute of the San Carlos Clinical Hospital (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3588-0557","authenticated-orcid":false,"given":"David","family":"Navarro\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry Complutense University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7973-9652","authenticated-orcid":false,"given":"Diego","family":"Le\u00f3n\u2010Herce","sequence":"additional","affiliation":[{"name":"University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry Complutense University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7351","authenticated-orcid":false,"given":"Aroa","family":"Tard\u00e1guila\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid Health Research Institute of the San Carlos Clinical Hospital (IdISSC)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-0265","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"L\u00e1zaro\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid Health Research Institute of the San Carlos Clinical Hospital (IdISSC)  Madrid 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