摘要
甲真菌病是一种常见、复发性真菌感染皮肤病,可造成甲板的变色和增厚,严重影响患者生活质量。显微镜检查和真菌培养是甲真菌病诊断的金标准技术,但高假阴性率推动了更准确的方法,如组织学和PCR。目前临床上有多种治疗方案可选择,而口服抗真菌药比局部治疗具有更高的治愈率和更短的治疗时间,但具有不良反应,如肝毒性和药物相互作用。局部治疗的不良反应较轻,但治愈率通常较低,治疗时间也要长得多。正在研究新的局部制剂,作为目前可用的局部治疗的速效替代品。激光等设备已显示出改善指甲美容外观的前景,但由于研究方法和治疗定义的高度变化,其对甲真菌病的有效性尚未得到充分证明。一旦感染,患者应尽快就医,预防性应用局部药物和避免在公共场所赤脚行走可能有助于预防复发。甲真菌病具有独特的中国流行病学特点,复发率高,影响患者生活质量,提示了其管理的必要性。本文将对甲真菌病的慢病管理定义、近年来的流行病学、辅助检查及治疗进展进行综述。
Onychomycosis is a common,recurrent fungal skin disease that can cause discoloration and thickening of the nail plate,which can seriously affect the quality of life of patients.Microscopy and fungal culture are the gold standard techniques for the diagnosis of onychomycosis,but the high false-negative rate drives more accurate methods such as histology and PCR.There are a variety of treatment options available in clinical practice,and oral antifungals have a higher cure rate and shorter treatment time than topical treatments,but have adverse side effects such as hepatotoxicity and drug interactions.Topical treatments have milder side effects,but the cure rate is usually lower and the duration of treatment is much longer.New topical formulations are being investigated as a quick-acting alternative to currently available topical treatments.Devices such as lasers have shown promise in improving the cosmetic appearance of nails,but their effectiveness against onychomycosis has not been fully demonstrated due to the high variability in research methods and treatment definitions.Patients should seek medical attention as soon as possible once infected,and prophylactic topical medications and avoiding walking barefoot in public places may help prevent recurrence.Onychomycosis has unique Chinese epidemiological characteristics,high recurrence rate,and affects the quality of life of patients,suggesting the necessity of its management.This article reviews the definition of chronic disease management,epidemiology,ancillary examinations and treatment progress of onychomycosis in recent years.
作者
班慧珍
陈韬宇
陈宏翔
BAN Huizhen;CHEN Taoyu;CHEN Hongxiang(Guangdong Medical University,Zhanjiang 524023,China;Department of Dermatology,Shiyan People′s Hospital,Shenzhen 518105,China)
出处
《皮肤科学通报》
2024年第1期111-116,共6页
Dermatology Bulletin
关键词
甲真菌病
慢病
治疗
预防
Onychomycosis
Chronic diseases
Treat
Prevention
