Onychomycosis is a very common condition in Brazil and one whose current treatments yield low cure rates, potential adverse effects, and drug interactions that limit their use. Recent studies have demonstrated laser therapy as a new, safe, and effective treatment option. This treatment was performed in 12 patients (with a total of 20 affected nails), with 3 application sessions of 1,064nm long pulse Nd:YAG laser, in two-week intervals. The results corroborate the current data of good clinical response and safety.

Keywords: ONYCHOMYCOSIS, LASERS, ADVANCED TREATMENT.

Introduction: The importance of early diagnosis and treatment of actinic keratoses is well established. There are several effective therapeutic options for the treatment of this condition. Objectives: To compare the efficacy and patient preference between 5% imiquimod cream and photodynamic therapy in the treatment of actinic keratoses. Methods: Twelve patients with a total of 245 lesions were treated with MAL-PDT and 5% imiquimod cream. Randomization was performed in order to determine the hemiface (left or right) for each treatment. First, the patients underwent MAL-PDT.After one month, they started using imiquimod in the other hemiface twice a week for 16 weeks.After six months, the two treatments were analyzed for efficacy, tolerability, patient preference, and aesthetic results using the observations of a blinded investigator. Results: Both treatments showed good therapeutic responses, with 72% of lesions treated with MAL-PDT and 76% of lesions treated with imiquimod having complete improvement. The average size of residual lesions was similar in the two treatments. Ten patients (83%) preferred the treatment with photodynamic therapy (p = 0.03). Conclusions: Photodynamic therapy and imiquimod are effective in the treatment of actinic keratoses. The results of this study showed similar efficacy and good aesthetic results with the two treatments. Nevertheless, most patients preferred the photodynamic therapy.

Keywords: KERATOSIS, ACTINIC; TREATMENT OUTCOME; THERAPEUTIC.