Comparative evaluation of therapeutic efficacy of cryotherapy with liquid nitrogen versus oral terbinafine pulse in finger nail onychomycosis

Background: Onychomycosis is a fungal infection of the nail unit and can be caused by dermatophytes, yeasts and non-dermatophyte moulds. None of the treatment modalities yield consistent results. Cryotherapy as a treatment modality has not been studied in its management.Methods: 80 clinically confirmed cases of onychomycosis were enrolled for the study. Cases in group 1 were given liquid nitrogen cryotherapy with dipstick method for 12 weeks at 2 weekly intervals and cases in group 2 were given oral terbinafine in a dose of 500 mg daily for a week/month for 3 months. After 12 weeks cases in both groups were followed up at intervals of 3 weeks till 24 weeks.Results: At week 12 ,40% of the patients in group 1 achieved clinical cure which was comparable to treatment with oral terbinafine pulse which was 45% and G3 response was attained by 20% of the patients in group 1 and 17.5% patients in group 2. The results at 12 weeks were comparable in two groups and p value was insignificant. At the end of study duration, clinical cure was achieved in 32.5% in group 1 and 62.5% of patients in group 2 and p value was highly significant.Conclusions: The results of cryotherapy were inferior to oral terbinafine pulse. Though results with cryotherapy were comparable to oral terbinafine pulse at 12 weeks, at 24 weeks oral terbinafine pulse proved to be a treatment option in finger nail onychomycosis.