{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:33:05Z","timestamp":1790346785056,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Onychomycosis is a fungal infection of the nails. Oral itraconazole inhibits lanosterol-14\u03b1 demethylase, impairing fungal cell membrane synthesis. The 1064\u2009nm\n                      <jats:italic toggle=\"yes\">Q<\/jats:italic>\n                      -switched Nd:YAG laser produces photothermolytic and photomechanical effects on fungi. Since both act via different mechanisms, their combination may offer additive benefits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      To compare the efficacy of oral itraconazole pulse therapy, 1064\u2009nm\n                      <jats:italic toggle=\"yes\">Q<\/jats:italic>\n                      -switched Nd:YAG laser therapy, and their combination in treating onychomycosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ninety Potassium hydroxide(KOH) mount- and culture-positive patients were randomized into 3 groups: itraconazole pulse (Group A), laser therapy (Group B), or combination therapy (Group C). Patients were followed for 9\u2009months with 3-month interval assessments. Onychomycosis Severity Index (OSI), KOH mount, and culture were evaluated at each visit. Complete cure, clinical and mycological cure, effectiveness, and failure rates were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All groups showed significant OSI reduction from baseline (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with no significant intergroup differences (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05). Clinical cure occurred in 20 patients (74.07%) in Group A, 20 (74.07%) in Group B, and 20 (80%) in Group C. No relapse occurred during follow-up. KOH and culture results did not differ significantly among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Laser therapy, alone or with itraconazole, was as effective as itraconazole pulse therapy. Given its efficacy and absence of systemic side effects, the Nd:YAG laser offers a safe alternative in managing onychomycosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/12034754251392072","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T06:42:54Z","timestamp":1763361774000},"page":"227-232","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Itraconazole Pulse Therapy Versus Q-Switched Nd-YAG Laser Versus Combination of Both in the Treatment of Onychomycosis-A Single-Blind Randomized Control Trial"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0533-7465","authenticated-orcid":false,"given":"Siddhartha","family":"Dash","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, SCB Medical College and Hospital, Cuttack, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasenjeet","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, IMS and SUM Medical College and Hospital-2, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9935-5711","authenticated-orcid":false,"given":"Manoj Kumar","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Dermatology, IMS and SUM Medical College and Hospital, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Dermatology, IMS and SUM Medical College and Hospital, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Public Health Dentistry, SCB Dental College and Hospital, Cuttack, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharitri","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Microbiology, SCB Medical College and Hospital, Cuttack, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0255-0857(21)01924-1"},{"key":"e_1_3_2_3_2","first-page":"51","article-title":"Onychomycosis: classification and diagnosis","volume":"3","author":"Gupta AK","year":"2004","unstructured":"Gupta AK, Jennifer E, Richard C, Ryder JE, Summerbell RC. Onychomycosis: classification and diagnosis. J Drug Dermatol. 2004;3:51-56.","journal-title":"J Drug Dermatol"},{"key":"e_1_3_2_4_2","volume-title":"Rook\u2019s Textbook of Dermatology","author":"Hay RJ","year":"2010","unstructured":"Hay RJ, Ashbee HR. Fungal infections. In: Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, eds. Rook\u2019s Textbook of Dermatology. 9th ed. Blackwell publishing, Ltd.; 2010: 32.48-32.49.","edition":"9"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000448056"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.37052"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.4.501"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3109\/09546634.2015.1066479"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.187858"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(97)70286-X"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.16619"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/379725"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12102"},{"key":"e_1_3_2_14_2","first-page":"496","article-title":"Treating onychomycoses of the toenail: clinical efficacy of the sub-millisecond 1,064 nm Nd:YAG laser using a 5 mm spot diameter","volume":"11","author":"Kimura U","year":"2012","unstructured":"Kimura U, Takeuchi K, Kinoshita A, Takamori K, Hiruma M, Suga Y. Treating onychomycoses of the toenail: clinical efficacy of the sub-millisecond 1,064 nm Nd:YAG laser using a 5 mm spot diameter. J Drugs Dermatol. 2012;11:496-504.","journal-title":"J Drugs Dermatol"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15601"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.12.024"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13798"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1203475419861071"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017948"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/1216907"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23200"},{"key":"e_1_3_2_22_2","first-page":"358","article-title":"Effect of 0.9-ms 1064-nm Nd:YAG laser combined with itraconazole for treatment of toenail onychomycosis","volume":"38","author":"Zhong Z","year":"2018","unstructured":"Zhong Z, Yang Y, Zhou S, et al Effect of 0.9-ms 1064-nm Nd:YAG laser combined with itraconazole for treatment of toenail onychomycosis. Nan Fang Yi Ke Da Xue Xue Bao. 2018;38:358-362.","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2019.1623861"}],"container-title":["Journal of Cutaneous Medicine and Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754251392072","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/12034754251392072","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/12034754251392072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:19:04Z","timestamp":1780661944000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/12034754251392072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,16]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/12034754251392072"],"URL":"https:\/\/doi.org\/10.1177\/12034754251392072","relation":{},"ISSN":["1203-4754","1615-7109"],"issn-type":[{"value":"1203-4754","type":"print"},{"value":"1615-7109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,16]]}}}