{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:33:52Z","timestamp":1790714032789,"version":"4.1.0"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["IJDVL"],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Onychomycosis accounts for 20-40% of all nail disorders. It is difficult to cure with resistance to anti-fungal drugs, their side effects and drug interactions limiting treatment options. Itraconazole is a widely accepted oral medication used for onychomycosis while fractional CO<jats:sub>2<\/jats:sub> laser along with a topical anti-fungal has shown promising results for nail plate clearance in onychomycosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Aim<\/jats:title>\n<jats:p>To compare the efficacy of fractional CO<jats:sub>2<\/jats:sub> laser with 1% terbinafine cream versus itraconazole in the management of onychomycosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective, randomised, single-centre, two-arm, parallel-group interventional study was conducted at Command Hospital Air Force, Bangalore. Onychomycosis cases confirmed by KOH mount\/culture-positive were included. Patients were randomly divided into two groups. Group A received 4 sessions of fractional CO<jats:sub>2<\/jats:sub> laser every fourth week with twice-daily application of 1% terbinafine cream; Group B received one-week pulse therapy with capsule itraconazole once every four-week for three pulses. The response was assessed by Onychomycosis Severity Index, a validated onychomycosis assessment scale, at baseline and at six months.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Results<\/jats:title>\n<jats:p>Group A had 50 patients with a total of 98 nails. Clinical improvement was seen in 83\/98 (84.7%) nails. The average reduction in Onychomycosis Severity Index was 8.65 (<jats:italic>P<\/jats:italic> &lt; 0.05). Group B had 50 patients with a total of 136 nails. Clinical improvement was seen in 104\/136 (76.5%) nails. The average reduction in Onychomycosis Severity Index was 7.37 (<jats:italic>P<\/jats:italic> &lt; 0.05). Both groups showed statistically significant improvement measured by \u2018Reduction in Onychomycosis Severity Index\u2019 at six months; however, there was no significant difference between the two arms.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st5\">\n<jats:title>Limitations<\/jats:title>\n<jats:p>The main limitations of the study are the small sample size and lack of long-term follow-up to assess recurrence of infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st6\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Fractional CO<jats:sub>2<\/jats:sub> laser with 1% terbinafine cream is an effective and safe method for inducing nail clearance in onychomycosis and has efficacy similar to itraconazole pulse therapy.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijdvl_98_2021","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T11:31:10Z","timestamp":1648726270000},"page":"47-53","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fractional CO<sub>2<\/sub> laser with topical 1% terbinafine cream versus oral itraconazole in the management of onychomycosis: A randomized controlled trial"],"prefix":"10.25259","volume":"89","author":[{"given":"Eeshaan","family":"Ranjan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Base Hospital, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Community Medicine & School of Public 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