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Abstract The present study could attest to the high efficacy as well as safety of the long pulsed Nd-YAG laser (1064nm) in the treatment of scaly ringworm (SRW) and adds another support to the old idea of mere induction of telogen as a sole effective line of treatment for this common type of scalp infections. Certain precautions could be recommended as thorough shaving, treating all scaly areas and even beyond, application of least effective dose, avoidance of overlap, treating all lesions and liberal use of topical antifungal for at least 6-8 weeks. Some modifications in the inclusion criteria or in the methodology may be considered in subsequent studies as inclusion of larger number of patients over wider age range, pretreatment total scalp shaving for proper delineation of infected areas, trial without topical antifungal, trial over wider range of fungal species, selection of cases resistant to other lines of treatment, histopathological analysis of lesions throughout the different stages and more frequent mycologic evaluation (for possible direct effect on fungal elements). There may be also the need for longer term follow up so as to detect any delayed recurrences (e.g. due to initially missed subclinical lesions). Suggestions can be also made to manipulate laser parameters (e.g. for none selective thermal damage of fungal elements) or to evaluate other laser or light modalities. |