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Onychomycosis is caused by the infection of nail plate and hyponychium with dermatophytes or other fungi. Currently, the treatment of onychomycosis includes topical or systemic antifungal agents as well as nail avulsion, whose application has been considerably limited by their disadvantages. Recently, light therapy has been introduced into the treatment of onychomycosis, which mainly includes photodynamic therapy and laser therapy. The mechanisms of light therapy mainly involve photochemical reaction and selective absorption of pulsed radiation. Multiple studies have suggested that photodynamic therapy and laser therapy are effective for the treatment of onychomycosis with few side effects. This review describes the mechanisms, efficacy and safety of these light therapies in onychomycosis.

[1]Gupta AK, Jain HC, Lynde CW, et al. Prevalence and epidemiology of onychomycosis in patients visiting physicians’ offices: a multicenter Canadian survey of 15,000 patients.J Am Acad Dermatol 2000;43:244-8. [2] ���,�����.���ڼ��������ԭѧ�����в�ѧ����.�й����ѧ��־.2006��2�µ�1���1�ڣ�63—64. [3] Krafchik B, Pelletier J. An open study of tinea cap itis in 50 children treated with a 22week course of oral terbinafine[ J ]. J Am Acad Dermatol, 1999, 41 (2) : 60263. [4] M Tuccori, F Bresci,et al.Fatal Hepatitis After Long-Term Pulse Itraconazole Treatment for Onychomycosis.The Annals of Pharmacotherapy: 2008,Vol. 42, No. 7��1112-1117. [5] TGM Smijs, J A Bouwstra,et al.Investigation of conditions involved in the susceptibility of the dermatophyte Trichophyton rubrum to photodynamic treatment.Journal of Antimicrobial Chemotherapy .2007; 60, 750–759 [6]. Babilas P, Landthaler M, Szeimies RM. Photodynamic therapy in dermatology.Eur J Dermatol. 2006;16(4):340-348. [7] H. Kamp, H.-J. Tietz, M. Lutz,et al.Antifungal effect of 5-aminolevulinic acid PDT in Trichophyton rubrum,Mycoses, 2005;48, 101–107 [8] TGM Smijs, AA Mulder, et al.Morphological changes of the dermatophyte Trichophyton rubrum after photodynamic treatment: a scanning electron microscopy study.Medical Mycology.2008, Vol. 46, No. 4 , 327-336 [9]Watanabe D, Kawamura C, Masuda Y, Akita Y, Tamada Y, Matsumoto Y. Successful treatment of toenail onychomycosis with photodynamic therapy.Arch Dermatol.2008;144:19–21. [10]Piraccini BM, Rech G, Tosti A. Photodynamic therapy of onychomycosis caused by Trichophyton rubrum. J Am Acad Dermatol. 2008;59:S75–6. [11]Sotiriou E, Koussidou-Eremonti T, Chaidemenos G,Apalla Z, Ioannides D. Photodynamic therapy for distal and lateral subungual toenail onychomycosis caused by Trichophyton rubrum: preliminary results of a single-centre open trial. Acta Derm Venereol. 2010;90:216–7. [12] CC Riddle, SN Terrell, MB Menser,et al.A review of photodynamic therapy (PDT) for the treatment of acne vulgaris.Journal of drugs in dermatology,2009, vol. 8, 1010-1019 [13] Gupta AK, Ahmad I, Borst I, Summebrbell RC.Detection of xanthomegnin in epidermal materials infected with Trichophyton rubrum. J Invest Dermatol 2000,115;901-905 [14] Suthamjariya K, Farinelli WA, Koh W, Anderson RR Mechanisms of microvascular response to laser pulses. J Invest Dermatol 2004,122;518-525 [15 ]Vural E, Winfield HL, Shingleton AW, Horn TD, Shafirstein G: The effects of laser irradiation on Trichophyton rubrum growth, Lasers Med Sci.2008 23; 349-353 [16]AS Landsman, AH Robbins,et al.Treatment of mild, moderate, and severe onychomycosis using 870-and 930-nm light exposure.Journal of the American Podiatric Medical Association,2010��Vol 100,3;166—177 [17]Harris DM, McDowell BA, Strisower J. Laser Treatment for toenail fungus. Photonics Therapeutics and Diagnostics V, SPIE Proc. 2009; Vol. 7161 [18]Kozarev J, Vizintin Z. Novel Laser Therapy in Treatment of Onychomycosis. J Laser Health Academy, 2010; 1:1-9. [19]LG Hochman.Laser treatment of onychomycosis using a novel 0.65-millisecond pulsed Nd: YAG 1064-nm laser. Journal of Cosmetic and Laser Therapy, 2011��13��2—5 [20] A Goldman, F Rossato,et al.Stretch Marks: Treatment Using the 1,064-nm Nd:YAG Laser. Dermatol Surgery 2008;34:686–692. [21] SB Cho, SJ Park,MJ Kim,et al.Treatment of acquired bilateral nevus of Ota�\like macules (Hori's nevus) using 1064�\nm Q�\switched Nd: YAG laser with low fluence.International Journal of Dermatology 2009; 48, 1308–1312. [22] Z Manevitch,D Lev,M Hochberg,et al.Direct Antifungal Effect of Femtosecond Laser on Trichophyton rubrum Onychomycosis.Photochemistry and Photobiology, 2010�� 86�� 476–479