Onychomysosis - 甲癣
受甲癣 (Onychomysosis) 影响的脚趾甲
接受Terbinafine(特比萘芬)口服治疗十周后，脚部出现指甲真菌感染。请注意受感染指甲后方的健康指甲生长带。
relevance score : -100.0%
References全身抗真菌药物是最有效的治疗方法。荟萃分析显示，真菌治愈率如下： terbinafine = 76%，itraconazole with pulse dosing = 63%，itraconazole with continuous dosing = 59%，fluconazole = 48% 。伴随的指甲清创进一步提高了治愈率。ciclopirox 局部治疗效果较差，其失败率超过 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%.
甲真菌病是一种影响指甲的真菌感染。当它由皮肤癣菌引起时，称为甲癣。甲真菌病包括皮肤癣菌、酵母菌和霉菌引起的感染。不是由真菌感染引起的指甲问题称为 nail dystrophy。虽然它可累及手指甲和脚趾甲，但趾甲甲真菌病更为常见。本文将讨论趾甲灰指甲的各个方面，包括其影响、临床类型、分期、诊断和治疗。甲真菌病虽不危及生命，但可导致严重并发症，如蜂窝织炎、败血症、骨感染、组织损伤和指甲脱落。
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 是一种通过阻断角鲨烯环氧酶来对抗真菌感染的药物。它对多种皮肤真菌有效，并已获批口服用于治疗甲真菌感染。虽然大多数副作用（如头痛、胃部不适）通常轻微且会自行消失，但味觉变化（味觉障碍）可能从轻微到严重，甚至导致体重下降。永久性味觉改变极为罕见，但已有相关报道。
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.
甲真菌病是一种影响指甲的真菌感染。约90%的脚趾甲感染和75%的手指甲感染由真菌引起，常见致病菌包括Trichophyton mentagrophytes和Trichophyton rubrum。症状主要表现为指甲变色、增厚、与甲床分离以及过度生长。治疗通常采用口服药物，如特比萘芬(Terbinafine)或伊曲康唑(Itraconazole)；轻度至中度病例也可选择局部治疗。
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.
口服抗真菌药物特比萘芬是最有效的治疗选择，但其可能导致肝脏副作用。
甲癣 (onychomysosis) 约影响 10% 的成年人口，老年人更易受累，男性的发病率高于女性。甲癣约占指甲疾病的一半，这意味着脚趾甲畸形也可能由其他原因引起。
○ 治疗 - 非处方药
外用药物治疗甲癣较为困难，因为药物难以渗透增厚的指甲。
#Ketoconazole
#Clotrimazole
#Miconazole
#Terbinafine
#Butenafine [Lotrimin]
#Tolnaftate
○ 治疗
通常需要长期治疗，直至受感染的指甲完全恢复。
#Terbinafine (oral)
#Itraconazole
#Efinaconazole lacquer [Jublia]
#Ciclopirox lacquer