# Quantitative Evaluation of the Clinical Evolution of Traumatic Onycholysis after Laser Treatment
###### Abstract  
Nail disorders are the most frequent reason for visits to the podiatry clinic. Although they are not a severe health problem, these types of pathologies have a psychosocial impact on patients, affecting their self-esteem and leading to social and professional self-isolation that can cause anxiety and depression. Laser therapy is considered a potential treatment for nail disorders because it is a fast, easily applied treatment that avoids interaction with medication. However, the literature includes no definitive studies with scientific evidence about the efficacy of laser treatment in traumatic onycholysis, the most frequent clinical sign of nail disorders. Objective: We carried out an objective and quantitative study of the efficacy of laser in treating traumatic onycholysis to provide a new, non-invasive treatment for this pathology, and describe an objective method for its clinical evaluation and evolution. Methods: A strictly repetitive protocol of Nd:YAG 1064 nm laser (PinPointe FootLaserTM, Spain) was applied to nails with idiopathic disorders, following the manufacturer's instructions. The clinical evolution of nail dystrophy was quantitatively evaluated using the affected percentage of the longitudinal axis of the nail. Results: A significant improvement was obtained in nail appearance (dystrophy) in 100% of cases (\(p<0.006\)) after treatment with Nd:YAG 1064 nm laser. Conclusion: Treating traumatic onycholysis with Nd:YAG 1064 nm laser can be a good alternative to conventional pharmacological treatments.  
Keywords: nail disorders; onycholysis; laser; treatment; clinical evaluation +
Footnote †: journal: Medical and Surgical Therapy, University Center of Extremadura, 10600 Plasencia, Spain; [EMAIL_ADDRESS]  
Footnote †: journal: Medical and Surgical Therapy, University Center of Extremadura, 1060 Plasencia, Spain; [EMAIL_ADDRESS]  
Footnote †: journal: Medical and Surgical Therapy, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain; [EMAIL_ADDRESS]  
Footnote †: journal: Medical and Surgical Therapy, University Center of Extremadura, 10600 Plasencia, Spain; iglesiasmj@gmail.  
Many pathologic nail abnormalities present onycholysis, including onychodystrophies caused by onychomycosis, psoriasis, lichen planus, trauantisms and the physiological changes of aging [10].  
Recent studies have brought advances in laser application for these nail disorders without the use of systemic treatment [12; 13] to meet the demand for new and more efficient treatments. Studies in which onychomycosis was treated with 1064 nm laser reported no definitive evidence to support the efficacy of laser in eliminating infections but concluded that the treatment is innocuous for sufferers and produces clinical improvement in the nails [13; 14], despite small structural changes in nail keratin [15]. Four works in the literature describe clinical cases of other nail disorders apart from onychomycosis and nail psoriasis treated with Nd:YAG 1064 nm laser: one on chronic paronychia, one on median canaliform nail dystrophy, a third on three clinical cases of idiopathic nail disorders, and a fourth on two cases of longitudinal melanonychia. In these studies, the disorders were treated heterogeneously [16; 17; 18; 19], with no objective evaluation.  
This study reports objective measurement of traumatic onycholysis, one of the main clinical signs of nail disorders, treated homogeneously with Nd:YAG 1064 nm laser, and describes an objective method for its clinical evaluation.