European Journal of Molecular & Clinical Medicine

Background: Onychomycosis, a fungus that affects the nails, is typically brought on by dermatophytes, as well as nondermatophytes, moulds, and yeasts. Using a fractional CO₂ laser to treat onychomycosis results in microscopic thermal wounds in the nails, which help topical antifungal medications penetrate the nail more effectively.
Aims and Objectives: To study the efficacy of fractional CO₂ laser assisted topical antifungal therapy for onychomycosis treatment in adult north Indian population.
Material & Method: In this study, 50 clinically suspected patients with onychomycosis had their nails examined by KOH examination and culture in both males and females over the age of 18. All patients underwent fractional CO₂ laser treatment every two weeks while also receiving randomly selected topical antifungal drugs for a total of six months. Clinical findings and the Scoring Clinical Index were used to analyse the nails of all the patients for onychomycosis.
Result: All patients with KOH and culture-proven onychomycosis had clinical improvement, as determined by calculating the Scoring Clinical Index for onychomycosis following the conclusion of treatment, since there was a significant drop in the score of SCIO in all patients.
Conclusion: Fractional CO₂ Laser assisted topical antifungal therapy is effective treatment for the onychomycosis in adult north Indian population.

Background: Onychomycosis is a chronic fungal infection of the nail, characterized by nail
discoloration, subungual hyperkeratosis, and onycholysis. The involved pathogens are
dermatophytes, yeasts (Candida), and non-dermatophyte molds.Dermatophytes such as
Trichophyton rubrum and Trichophyton mentagrophytes are the most common agents of
onychomycosis, with higher prevalence of the infection in toenails than in fingernails. Candida
albicans affects almost exclusively the fingernails, and accounts for 10% of toenail
onychomycosis.
Itraconazole is a broad-spectrum antifungal drug which is active against a range of fungal
species, including yeasts, dermatophytes and some non-dermatophyte molds, is a more
convenient antifungal drug for different types of onychomycosis. Itraconazole is licensed at a
dose of 200 mg daily for 12 weeks continuously or intermittently as pulse therapy at a dose of
400 mg daily for 1 week per month for 2-3 pulses in fingernail infections and 3-4 pulses for
toenail disease.Although itraconazole pulse therapy has proven to be an effective and
acceptable onychomycosis therapies, the complete cure rate remains unsatisfactory, indicating
that 3-4 cycles of pulse therapy for toenail onychomycosis might be inadequate for severe cases
of onychomycosis. Thus, the development of a more effective and suitable therapeutic regimen
to improve the complete cure rate is necessary.