Onychomycosis - 甲真菌症
受甲真菌症 (Onychomycosis)影響的腳趾甲
接受特比萘芬口服藥物治療十週後，腳部出現指甲真菌感染。注意剩餘受感染指甲後面的健康指甲生長帶。
relevance score : -100.0%
References全身性抗真菌藥物是最有效的治療方法。薈萃分析顯示真菌治癒率如下： terbinafine = 76%， itraconazole（脈衝劑量）= 63%， itraconazole（持續劑量）= 59%， fluconazole = 48% 。伴隨指甲清創可進一步提高治癒率。ciclopirox 局部治療效果較差，其失敗率超過 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%.
甲真菌病是一種影響指甲的真菌感染。當它由皮癬菌引起時，稱為甲癬。甲真菌病包括由皮癬菌、酵母菌和黴菌引起的感染。不是由真菌感染引起的指甲問題稱為 nail dystrophy。雖然它可影響手指甲和腳趾甲，但趾甲甲真菌病較為常見。本文討論趾甲灰指甲的各個方面，包括其影響、臨床類型、發展階段、診斷與治療。甲真菌病雖不致命，卻可能導致嚴重併發症，如蜂窩性組織炎、敗血症、骨感染、組織損傷及指甲脫落。
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 是一種透過阻斷角鯊烯環氧酶來對抗真菌感染的藥物。它對多種皮膚真菌有效，且已獲批准口服治療指甲真菌感染。雖然大多數副作用（例如頭痛和胃部不適）都較輕微且會自行消失，但味覺變化（味覺障礙）可能從輕微到嚴重，有時甚至導致體重減輕。永久性的味覺改變很少見，但已有相關報告。
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.
甲真菌病是一種影響指甲的真菌感染。約有 90% 的腳趾甲感染與 75% 的手指甲感染是由真菌引起，常見致病菌包括 Trichophyton mentagrophytes、Trichophyton rubrum。症狀可能包括指甲變色、增厚、與甲床分離以及過度生長。治療通常使用口服藥物，如特比萘芬(Terbinafine)或伊曲康唑(Itraconazole)；對於輕度至中度病例，也可選擇局部治療。
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.
口服抗真菌藥物特比萘芬 (terbinafine) 似乎是最有效的，但其使用與肝臟副作用相關。
甲真菌症 (onychomycosis) 約影響 10% 的成年人口，老年人較易罹患，男性發病率高於女性。甲真菌症 (onychomycosis) 約佔指甲疾病的一半，這意味著腳趾甲畸形也可能源於其他原因。
○ 治療 - 非處方藥
外用藥物治療甲癬較為困難，因為藥物難以滲透增厚的腳趾甲。
#Ketoconazole
#Clotrimazole
#Miconazole
#Terbinafine
#Butenafine [Lotrimin]
#Tolnaftate
○ 治療
通常需要長期治療，直到感染的腳趾甲完全移除。
#Terbinafine (oral)
#Itraconazole
#Efinaconazole lacquer [Jublia]
#Ciclopirox lacquer