Photodynamic Therapy with Methyl 5-aminolevulinic Acid for Treatment of Toenail Onychomycosis: the Efficacy and Safety

Lee, See Hyun; Park, Mi Youn; Ahn, Ji Young

Abstract

BACKGROUND
The major limitations of the current therapeutic treatments for onychomycosis are the recurrence of the infection and the duration of the treatment. Recently, photodynamic therapy (PDT) is thought to be a novel alternative method for treatment of onychomycosis.
OBJECTIVE
The aim of this study is to investigate the efficacy and safety of PDT with methyl 5-aminolevulinic acid (MAL) for the treatment of onychomycosis.
METHODS
We performed MAL-PDT in eight patients with distal subungual onychomycosis on at least one great toenail. After the total three treatments, we observed the clinical and mycological courses for twelve months.
RESULTS
For the twelve months of follow-up period, three patients (37.5%) showed continuous clinical improvement, two patients (25%) aggravation after transient improvement, and the rest, three patients (37.5%) resistance to treatment. All subjects complained of quite severe burning pain during irradiation of light source.
CONCLUSION
In this study, we observed the highly variable clinical and mycological results of PDT in onychomycosis. We concluded that it is too difficult to consistently achieve the best fungicidal effect by PDT without strictly selected conditions.