CO₂ Laser-Assisted Nail Sampling for Mycological Testing in Onychomycosis

Area of Science:

• Dermatology
• Mycology
• Medical Technology

Background:

• Onychomycosis is the most common nail infection, often caused by Trichophyton spp.
• Accurate diagnosis relies on mycological examination, but obtaining sufficient samples can be difficult.
• Current sampling methods may cause patient discomfort and yield inadequate specimens.

Purpose of the Study:

• To evaluate the efficacy and patient experience of using a carbon dioxide (CO2) laser for nail sample collection in onychomycosis.
• To determine if CO2 laser use improves sample adequacy and reduces pain during mycological examination.

Main Methods:

• A retrospective study of 25 patients with distolateral onychomycosis.
• Nail plates were detached using a CO2 laser (10 W, continuous mode) at the proximal border.
• Nail bed curettage and collection of subungual debris and plate fragments for KOH testing and culture.

Main Results:

• The mean visual analog score (VAS) for pain was 0.7, indicating a relatively painless procedure for most patients.
• No permanent nail unit changes were observed post-procedure during follow-up.
• The CO2 laser facilitated sample collection, ensuring adequate material for diagnosis.

Conclusions:

• CO2 laser use is a safe and effective method for detaching nail plates for onychomycosis sampling.
• The technique offers advantages such as ease of use, reduced pain, and precise targeting of infected areas.
• This method enhances the ability to obtain viable fungal specimens for accurate diagnosis.