Onychomysosis - 甲癣
受甲癣 (Onychomysosis)影响的脚趾甲
接受特比萘芬口服药物治疗十周后，脚部出现指甲真菌感染。注意剩余受感染指甲后面的健康指甲生长带。
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；其故障率超过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。当它是由皮肤癣菌引起时，称为甲癣。甲真菌病包括由皮肤癣菌、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 。虽然它可以影响手指甲和脚趾甲，但趾甲甲真菌病更为常见。本文讨论趾甲灰指甲的各个方面，例如其影响、临床类型、阶段、诊断和治疗。虽然甲真菌病不会危及生命，但它会导致严重的并发症，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，并被批准口服用于治疗指甲真菌。虽然大多数副作用（例如头痛和胃部问题）都很轻微并且会自行消失，但味觉变化（味觉障碍）可能从轻微到严重，有时会导致体重减轻。永久性的味觉改变很少见，但已有报道。
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。大约 90% 的脚趾甲感染和 75% 的指甲感染是由真菌引起的 (Trichophyton mentagrophytes, Trichophyton rubrum) 。症状包括指甲变色、增厚、与甲床分离和过度生长。治疗通常包括特比萘芬或伊曲康唑等口服药物，轻度至中度病例可以选择局部治疗。
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似乎是最有效的，但特比萘芬与肝脏副作用有关。
甲癣 (onychomysosis) 发生在大约 10% 的成年人口中，其中老年人更容易受到影响。男性比女性更容易受到影响。 甲癣 (onychomysosis) 约占指甲疾病的一半。这意味着脚趾甲的畸形也可能来自甲真菌病以外的原因。
○ 治疗 - 非处方药
用外用药物治疗甲癣很困难，因为药物很难渗透到增厚的脚趾甲中。
#Ketoconazole
#Clotrimazole
#Miconazole
#Terbinafine
#Butenafine [Lotrimin]
#Tolnaftate
○ 治疗
通常需要长期治疗，直到感染的脚趾甲完全去除。
#Terbinafine (oral)
#Itraconazole
#Efinaconazole lacquer [Jublia]
#Ciclopirox lacquer