Recalcitrant Curvularia Onychomycosis Favourable Treatment Response to Q Switch Nd YAG Laser

Authors: Mehra M*, Gahalaut P and Shekhar A

DOI: 10.23880/cdoaj-16000313

Volume 8, Issue 3

Abstract

We report the case of an immunocompetent 51 year old female with fingernail onychomycosis for 15 years. There was no response to multiple courses of anti fungals (terbinafine, itraconazole, griseofulvin) over the years. Upon SDA culture, causative agent was found to be Curvularia lunata. Patient was started on Itraconazole monthly pulse with daily Terbinafine. After 2 months of no improvement, biweekly sittings of 1064nm Q-switched Nd:YAG (fluence 350 mJ/cm2 over a 2-mm spot at a 5-Hz frequency with two applications in squared form across nail plate). After 8 such sittings, patient showed marked improvement. Q-switched Nd:YAG laser is a promising treatment for recalcitrant onychomycosis as evidenced by our case report. It acts by selective photothermal and photomechanical effect targeting melanin in fungal cell wall. Further studies are needed towards the establishment of standard treatment schedules, as well as the optimum fluency, length and format

Keywords: Curvularia; Recalcitrant Onychomycosis Treatment; Q-switched Nd-YAG Laser

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