PDF(Pubmed)
Abstract：
The emergence and spread of Trichophyton indotineae (T. indotineae) has led to a sea change in the prescription practices of clinicians regarding the management of dermatophytic skin infections. An infection easily managed with a few weeks of antifungals, tinea corporis or cruris, is now often chronic and recurrent and requires prolonged treatment. Rising resistance to terbinafine, with documented squalene epoxidase (SQLE) gene mutations, and slow clinical response to itraconazole leave clinicians with limited treatment choices. However, in these testing times, it is essential that the tenets of antifungal stewardship be followed in making therapeutic decisions, and that the existing armamentarium of antifungals be used in rationale ways to counter this extremely common cutaneous infection, while keeping the growing drug resistance among dermatophytes in check. This review provides updated evidence on the use of various systemic antifungals for dermatophytic infection of the glabrous skin, especially with respect to the emerging T. indotineae species, which is gradually becoming a worldwide concern.
摘要：
吲哚毛癣菌的出现和传播(T.indotineae）导致临床医生在治疗皮肤科皮肤感染方面的处方实践发生了巨大变化。几周的抗真菌药物很容易控制感染，体癣或股癣，现在通常是慢性和复发性的，需要长期治疗。对特比萘芬的抵抗力上升，有记载的角鲨烯环氧酶（SQLE）基因突变，对伊曲康唑的缓慢临床反应使临床医生的治疗选择有限。然而,在这些测试时间里，在做出治疗决定时，必须遵循抗真菌管理的原则，现有的抗真菌药库以合理的方式使用，以对抗这种极其常见的皮肤感染，同时控制皮肤癣菌之间日益增长的耐药性。这篇综述提供了有关使用各种全身性抗真菌药治疗无毛皮肤皮肤癣菌感染的最新证据，特别是关于新兴的吲哚科，正逐渐成为全世界关注的问题。
