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| LITERATURE REVIEW | PEER-REVIEW Laser speckle imaging is capable of measuring


tissue perfusion at high temporal and spatial resolution. It can be used to accurately quantitate microvascular reactivity following ischaemic and hyperthermic challenges 8


. Matrix-assisted laser desorption/ionisation time-of-


flight mass spectrometry is a mass spectrometric peptide analysis technique. For the diagnosis of onychomycosis, it was characterised as a Ôprecise, robust and fast tool in diagnostic investigation of nail disorders, which is superior to common standard methods Õ 9 dermatophyte species to be identified 10


. It even allowed .


Laser-induced breakdown spectroscopy with discriminant function analysis (DFA) allowed users to investigate normal nails 11


and discriminate samples


between the nails of healthy male subjects and opium addicts with the help of spectral line intensities of elements, including iron, carbon, titan, magnesium, silicium, aluminium, calcium, hydrogen, potassium, oxygen, and sodium 12 , 13 Laser nail ablation uses high-energy lasers to


.


depends on the type of ingrown nail, the most common form being distal lateral ingrowing. Matrix destruction achieves better results than matrix preservation. Carbon dioxide (CO2


especially for matrix horn ablation 16,17


treatment techniques have been reported: ■ Vapourisation of the nail matrix with or without section at the angle of the proximal and lateral nail folds 18


■ Matricectomy with CO2 laser after nail matrix staining 19


■ Matricectomy associated with vapourisation of the lateral fold, lateral groove, and granulation tissue 20


. The advantage of the CO2 laser is that it allows the skin The main indications


for laser treatments of the nail are ingrown nails,


ablate portions of the nail plate surface, the fumes of which are analysed and allow multiple elements in the nail to be determined. This is achieved with the use of double-focusing sector field inductively coupled plasma mass spectrometry and studying intra-individual long- and short-term chronological variations, as well as depth distribution patterns14


.


Lasers in the therapy of various nail conditions The main indications for laser treatments of the nail are ingrown nails, onychomycosis, psoriasis, and a range of tumours and pseudotumours.


Ingrown nails Ingrown nails are a common ailment significantly interfering with daily work, sports activities, and lowering overall quality of life. The number of different treatment recommendations is immense 15


. The choice of technique


Onychomycosis Onychomycoses are a group of fungal nail infections that, despite all progress in drug therapy, are still often refractory to medical treatment. New effective topical treatments are needed and laser therapy would be an alternative to the existing treatments. Originally, laser treatment applications were used to create holes in the nails, providing a pathway for the topical treatments to enter the nail 22


. Laser therapy involves direct application


of laser energy to the treatment site. A study demonstrated the effect of a 1064 nm QS Nd: YAG laser on growth inhibition of Trichophyton rubrum in vitro 23


, Figure 1 Procedure for laser beam vaporisation


onychomycosis, psoriasis, various tumours and pseudotumours.


to be cut with the focused superpulse mode beam, and to vapourise the tissue with the continuous mode. Parameters used are variable depending on the device. The CO2


laser only causes moderate


bleeding because the laser cauterises small blood vessels. Postoperative pain is moderate, infection is rare. It is a time-saving technique that allows precise and selective matrix horn destruction, and healing is fast (Figure 1). Recurrence rates are variable in the authorsÕ experience. The CO2


laser may also be


used to reduce a hypertrophic lateral nail fold or to perform DuboisÕs plasty with less bleeding and less


postoperative pain compared with traditional surgery. It has also been used with success to treat pincer nail deformity 21


.


) lasers have been used since the 1980s, . A number of


The nail fold is incised at both sides to allow it to be reflected


Space over the lateral matrix horn opened to allow access of laser beam


Vapourisation of the matrix horn is complete


The incisions of the proximal nail fold are sutured


prime-journal.com | March 2013 ❚


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