PDF(Pubmed)
Abstract：
The purpose of this review is to consolidate and summarize laser-assisted drug delivery (LADD) for nail diseases, particularly onychomycosis and psoriasis. A PubMed search was conducted in June 2023 using search terms (1) \"laser assisted drug delivery\" AND \"nail,\" (2) \"laser\" AND \"nail,\" and (3) \"nail disorder\" AND \"laser treatment.\" References of papers were also reviewed, yielding 15 papers for this review. Fractional ablative CO2 laser (FACL) and Er:YAG laser can be used for LADD of topical medications such as amorolfine, terbinafine, and tioconazole to treat onychomycosis. A fungal culture should be performed to determine the type of dermatophyte, which will help determine which topical will be most effective. Laser settings varied between studies, but overall LADD tended to be more effective than topical treatments alone. Laser-assisted photodynamic therapy (PDT) was also found to be effective in treating onychomycosis. For psoriatic nails, LADD was used to deliver calcipotriol-betamethasone dipropionate foam, tazarotene, triamcinolone, or methotrexate into the nail. Again, LADD was found to be significantly more effective than topical treatment alone. FACL was the only laser noted for use for LADD in both diseases. Laser-assisted drug delivery for nail disease is a newer approach for onychomycosis and nail psoriasis with several benefits and drawbacks. Dermatologists should discuss the option of LADD with their patients who have recalcitrant onychomycosis or nail psoriasis.
摘要：
这篇综述的目的是巩固和总结激光辅助药物递送（LADD）治疗指甲疾病，特别是甲癣和牛皮癣。在2023年6月进行了PubMed搜索，使用搜索词（1）“激光辅助药物输送”和“指甲”，\"(2)\"激光\"和\"钉,\"和（3）\"指甲障碍\"和\"激光治疗。\“论文的参考文献也进行了审查，为这篇综述发表了15篇论文。分数消融CO2激光（FACL）和Er：YAG激光可用于局部药物的LADD，例如amorolfine，特比萘芬,和噻康唑治疗甲癣。应进行真菌培养以确定皮肤癣菌的类型，这将有助于确定哪种主题最有效。不同研究之间的激光设置不同，但总体LADD往往比单独的局部治疗更有效。还发现激光辅助光动力疗法（PDT）可有效治疗甲癣。对于牛皮癣指甲，LADD用于递送卡泊三醇-二丙酸倍他米松泡沫，他扎罗汀,曲安奈德,或者甲氨蝶呤进入指甲.再一次,发现LADD比单独的局部治疗明显更有效。FACL是唯一一种用于两种疾病的LADD的激光。用于指甲疾病的激光辅助药物递送是用于甲癣和指甲牛皮癣的较新方法,具有若干益处和缺点。皮肤科医生应与患有顽固性甲癣或指甲牛皮癣的患者讨论LADD的选择。
