The effectiveness of combined photodynamic therapy and a shortened course of systemic antimycotics in comparison with standard onychomycosis therapy
https://doi.org/10.21518/ms2026-053
Abstract
Introduction. Onychomycosis is a chronic fungal infection of the nails, for the treatment of which prolonged courses of systemic antifungal agents are traditionally used, often accompanied by adverse reactions. A promising method that makes it possible to reduce the drug burden is photodynamic therapy (PDT).
Aim. To assess the efficacy and safety of combination treatment of onychomycosis using PDT.
Materials and methods. A prospective comparative study included 48 patients with clinically and mycologically confirmed onychomycosis. The control group (n = 24) received standard systemic antifungal therapy. The main group (n = 24) underwent 8 PDT sessions with a chlorin-containing photosensitizer in combination with a shortened course of systemic antimycotics. Efficacy was evaluated at 3, 6 and 9 months based on microscopy findings and the area of visually healthy nail plate. Additionally, a modified OnyCOE-T quality-of-life questionnaire was used.
Results. Both groups demonstrated improvement; however, the proportion of early mycological cure at month 3 in the main group was 1.36 times higher (p ≤ 0.05). By month 9, mycological and clinical cure was achieved in 96% of patients in the main group and in 87.5% of patients in the control group. Adverse reactions were recorded only with standard systemic therapy. According to OnyCOE-T, combination treatment was associated with a marked improvement in quality of life.
Conclusion. PDT as part of combination therapy for onychomycosis increases the rate of mycological and clinical cure, allows a reduction in the duration and risk of adverse effects of systemic antifungal therapy, and improves patients’ quality of life.
About the Authors
E. I. Tsygankova
Pirogov Russian National Research Medical University;
Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology
Russian Federation
Russian Federation
Ekaterina I. Tsygankova, Postgraduate Student of the Department of Skin Diseases and Cosmetology; Dermatovenerologist
1, Ostrovityanov St., Moscow, 117997;
17, Leninsky Ave., Moscow, 119071
V. Yu. Vasenova
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Victoria Yu. Vasenova, Dr. Sci. (Med.), Professor of the Department of Skin Diseases and Cosmetology
1, Ostrovityanov St., Moscow, 117997
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For citations:
Tsygankova EI, Vasenova VY. The effectiveness of combined photodynamic therapy and a shortened course of systemic antimycotics in comparison with standard onychomycosis therapy. Meditsinskiy sovet = Medical Council. 2026;(2):40-47. (In Russ.) https://doi.org/10.21518/ms2026-053
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