Onychomysosis - 甲真菌症
受甲真菌症 (Onychomysosis)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。
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 with pulse dosing = 63%, itraconazole with continuous dosing = 59%, fluconazole =48% 。伴隨的指甲清創進一步提高了治癒率。 ciclopirox 局部治療效果較差；其故障率超過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。當它是由皮癬菌引起時，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 。雖然它可以影響手指甲和腳趾甲，但趾甲甲真菌病更為常見。本文討論趾甲灰指甲的各個方面，例如其影響、臨床類型、階段、診斷和治療。雖然甲真菌病不會危及生命，但它會導致嚴重的併發症，如蜂窩性組織炎、敗血症、骨感染、組織損傷和指甲脫落。
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，並被批准口服用於治療指甲真菌。雖然大多數副作用（例如頭痛和胃部問題）都很輕微且會自行消失，但味覺變化（味覺障礙）可能從輕微到嚴重，有時會導致體重減輕。永久性的味覺改變很少見，但已有報告。
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。大約 90% 的腳趾甲感染和 75% 的指甲感染是由真菌引起的 (Trichophyton mentagrophytes, Trichophyton rubrum) 。症狀包括指甲變色、增厚、與甲床分離和過度生長。治療通常包括特比萘芬或伊曲康唑等口服藥物，輕度至中度病例可選擇局部治療。
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似乎是最有效的，但特比萘芬與肝臟副作用有關。
甲真菌症 (onychomysosis) 發生在大約 10% 的成年人口中，其中老年人更容易受到影響。男性比女性更容易受到影響。 甲真菌症 (onychomysosis) 約佔指甲疾病的一半。這意味著腳趾甲的畸形也可能來自甲黴菌病以外的原因。
○ 治療 - 非處方藥
用外用藥物治療甲癬很困難，因為藥物很難滲透到增厚的腳趾甲。
#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