Onychomysosis - Neglesvamp
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En tånegl påvirket af Neglesvamp (Onychomysosis)
En persons fod med en svampe-negleinfektion ti uger inde i et kursus med terbinafin oral medicin. Bemærk båndet med sund neglevækst bag de resterende inficerede negle.
References
Systemiske antimykotika er den mest effektive behandling. Metaanalyser viser mykotiske helbredelsesrater som følger: terbinafine = 76%, itraconazole with pulse dosing = 63%, itraconazole with continuous dosing = 59%, fluconazole =48% . Samtidig debridering af neglene øger hærdningshastigheden yderligere. Topisk terapi med ciclopirox er mindre effektiv; den har en fejlprocent på over 60 %.
Systemic antifungals are the most effective treatment. Meta-analyses shows mycotic cure rates as follows: terbinafine = 76%, itraconazole with pulse dosing = 63%, itraconazole with continuous dosing = 59%, fluconazole =48%. Concomitant nail debridement further increases cure rates. Topical therapy with ciclopirox is less effective; it has a failure rate exceeding 60%.
Systemic antifungals are the most effective treatment. Meta-analyses shows mycotic cure rates as follows: terbinafine = 76%, itraconazole with pulse dosing = 63%, itraconazole with continuous dosing = 59%, fluconazole =48%. Concomitant nail debridement further increases cure rates. Topical therapy with ciclopirox is less effective; it has a failure rate exceeding 60%.
Onychomycosis er en svampeinfektion, der påvirker neglene. Når det er forårsaget af dermatofytter, kaldes det tinea unguium. Onychomycosis omfatter infektioner forårsaget af dermatofytter, gær og skimmelsvamp. Et negleproblem, der ikke er forårsaget af en svampeinfektion, kaldes en nail dystrophy. Selvom det kan påvirke både fingernegle og tånegle, er tånegles onychomycosis mere almindelig. Denne artikel diskuterer forskellige aspekter af toenail onychomycosis, såsom dens virkning, kliniske typer, stadier, diagnose og behandling. Selvom det ikke er livstruende, kan onychomycosis føre til alvorlige komplikationer som cellulitis, sepsis, knogleinfektion, vævsskader og negletab.
Onychomycosis is a fungal infection of the nail unit. When dermatophytes cause onychomycosis, this condition is called tinea unguium. The term onychomycosis encompasses the dermatophytes, yeasts, and saprophytic mold infections. An abnormal nail not caused by a fungal infection is a dystrophic nail. Onychomycosis can infect both fingernails and toenails, but onychomycosis of the toenail is much more prevalent. Discussed in detail in this activity are all evolving facets of the topic, including disease burden, clinical types, staging, diagnosis, and management of toenail onychomycosis. While non-life-threatening, onychomycosis can lead to severe complications such as cellulitis, sepsis, osteomyelitis, tissue damage, and nail loss.
Onychomycosis is a fungal infection of the nail unit. When dermatophytes cause onychomycosis, this condition is called tinea unguium. The term onychomycosis encompasses the dermatophytes, yeasts, and saprophytic mold infections. An abnormal nail not caused by a fungal infection is a dystrophic nail. Onychomycosis can infect both fingernails and toenails, but onychomycosis of the toenail is much more prevalent. Discussed in detail in this activity are all evolving facets of the topic, including disease burden, clinical types, staging, diagnosis, and management of toenail onychomycosis. While non-life-threatening, onychomycosis can lead to severe complications such as cellulitis, sepsis, osteomyelitis, tissue damage, and nail loss.
Terbinafine er en medicin, der bekæmper svampeinfektioner ved at blokere squalenepoxidase. Det er effektivt mod mange typer hudsvampe og er godkendt til behandling af neglesvamp, når det tages oralt. Mens de fleste bivirkninger som hovedpine og maveproblemer er mindre og går over af sig selv, kan ændringer i smag (dysgeusi) variere fra mild til svær, nogle gange føre til vægttab. Permanente smagsændringer er sjældne, men er blevet rapporteret.
Terbinafine is an antifungal medication that works through the inhibition of squalene epoxidase. It has activity against most dermatophytes, and it has approval for use as an oral therapy for the treatment of onychomycosis. Although most side effects are mild and self-limited, such as headache and gastrointestinal symptoms, taste disturbances (dysgeusia) can range from mild to severe, resulting in weight loss, and have rarely been reported permanent.
Terbinafine is an antifungal medication that works through the inhibition of squalene epoxidase. It has activity against most dermatophytes, and it has approval for use as an oral therapy for the treatment of onychomycosis. Although most side effects are mild and self-limited, such as headache and gastrointestinal symptoms, taste disturbances (dysgeusia) can range from mild to severe, resulting in weight loss, and have rarely been reported permanent.
Onychomycosis er en svampeinfektion, der påvirker negle. Omkring 90 % af tånegleinfektioner og 75 % af negleinfektioner er forårsaget af svampe (Trichophyton mentagrophytes, Trichophyton rubrum) . Symptomerne omfatter misfarvning af neglene, fortykkelse, adskillelse fra neglebunden og overvækst. Behandling involverer typisk oral medicin som terbinafin eller itraconazol, hvor topiske behandlinger er en mulighed for milde til moderate tilfælde.
Onychomycosis is a fungal infection of the nail unit. Approximately 90% of toenail and 75% of fingernail onychomycosis are caused by dermatophytes, notably Trichophyton mentagrophytes and Trichophyton rubrum. Clinical manifestations include discoloration of the nail, subungual hyperkeratosis, onycholysis, and onychauxis. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis.
Onychomycosis is a fungal infection of the nail unit. Approximately 90% of toenail and 75% of fingernail onychomycosis are caused by dermatophytes, notably Trichophyton mentagrophytes and Trichophyton rubrum. Clinical manifestations include discoloration of the nail, subungual hyperkeratosis, onycholysis, and onychauxis. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis.
Den svampedræbende medicin terbinafin indtaget gennem munden ser ud til at være den mest effektive, men terbinafin er forbundet med leverbivirkningen.
neglesvamp (onychomysosis) forekommer hos omkring 10 procent af den voksne befolkning, hvor ældre mennesker er hyppigere ramt. Hanner rammes oftere end kvinder. neglesvamp (onychomysosis) repræsenterer omkring halvdelen af neglesygdomme. Det betyder, at tåneglenes deformitet også kan komme af andre årsager end onychomycosis.
○ Behandling - håndkøbsmedicin
Det er svært at behandle onychomycosis med topisk medicin, fordi det er svært for lægemidler at trænge ind i de fortykkede tånegle.
#Ketoconazole
#Clotrimazole
#Miconazole
#Terbinafine
#Butenafine [Lotrimin]
#Tolnaftate
○ Behandling
Langtidsbehandling er normalt påkrævet, indtil den inficerede tånegl er helt fjernet.
#Terbinafine (oral)
#Itraconazole
#Efinaconazole lacquer [Jublia]
#Ciclopirox lacquer