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Methylene blue vs methyl aminolevulinate photodynamic therapy in the treatment of mild‐to‐moderate toenail onychomycosis: Short‐ and medium‐term effects
Author(s) -
Alberdi Enrique,
Gómez Clara
Publication year - 2020
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14280
Subject(s) - photodynamic therapy , medicine , methylene blue , photosensitizer , randomized controlled trial , dermatology , cure rate , surgery , nail disease , clinical trial , complication , biochemistry , chemistry , organic chemistry , photocatalysis , catalysis
Photodynamic therapy (PDT) has emerged as an interesting alternative option for onychomycosis treatment. The impact of a specific photosensitizer (PS) on the final result is an important factor to consider. We conducted a short‐ and medium‐term controlled trial to compare the effectiveness of PDT in the treatment of mild‐to‐moderate onychomycosis when it is mediated by two different PSs. Twenty patients were randomized to receive nine sessions of PDT distributed over 16 weeks mediated either by methylene blue (MB/PDT group) or methyl aminolevulinate (MAL/PDT group). Onychomycosis severity index (OSI) and nail involvement were checked along the study. Complete cure, treatment success, and clinical improvement were tabulated at 16 and 40‐week follow‐ups. OSI scores decreased significantly along the study, from 12.1 ± 5.4 to 3.6 ± 3.2 (MB/PDT group) and from 14.8 ± 6.0 to 5.4 ± 4.4 (MAL/PDT group). At 16‐week follow‐up, only 20% of the patients in the MB/PDT group reached complete cure and none in the group of MAL/PDT. At 40‐week follow‐up, complete cure rates were 70% and 40% in the MB/PDT group and MAL/PDT group respectively. Both modalities showed good outcomes in treatment of moderate toenail onychomycosis. MB/PDT showed a faster action but with relapse rates slightly higher than MAL/PDT.