Exploring Different Dose-frequency Home Photodynamic Therapy Protocols Using a Novel Home-targeted LED Device for Onychomycosis

Inclusion Criteria: * Patients diagnosed with onychomycosis (nail fungal infection) by a dermatologist. * Diagnosis criteria include at least one clinical criterion combined with at least one laboratory examination criterion. Clinical Criteria: * Discoloration patches/streaks on the nail. * Onycholysis (nail separation from the nail bed). * Subungual hyperkeratosis/debris (thickening under the nail). * Nail plate thickening. * Laboratory Examination Criteria: * Direct microscopy using KOH preparation. * Histopathological examination using Periodic Acid Schiff (PAS) stain. * Patients with distal lateral subungual onychomycosis (DLSO) of the fingernails or toenails, except for the little toenail. * Patients with onychomycosis who have limitations on or refuse oral antifungal treatment. * Individuals willing to participate in the research after receiving a full explanation of the research details, able to comply with the research procedures, and have signed the informed consent form. Exclusion Criteria: * Presence of nail abnormalities caused by other diseases or conditions. * Pregnant or breastfeeding. * History of receiving oral antifungal agents within the past 6 months or topical antifungal agents within the past 1 month prior to enrollment. * History of photosensitivity or photodermatitis. * Known allergy to methylene blue. * Presence of erythematous or oedematous inflammatory skin conditions near the site of onychomycosis. * Severe peripheral arterial disease. * Uncontrolled diabetes mellitus or HbA1C \> 8%. * Immunocompromised status, such as HIV infection with CD4 count \< 200 cells/mm³ or diagnosis of Acquired Immunodeficiency Syndrome (AIDS). * Current use of immunosuppressive medications, including Tacrolimus, Azathioprine, Cyclosporine, Mycophenolate mofetil, or Prednisolone \>10 mg/day.