■足癣是皮肤最常见的浅表真菌感染之一,临床表现多样。这篇综述旨在使医生熟悉临床特征,足癣的诊断和治疗。
2023年4月,在PubMed临床查询中使用关键术语“足癣”或“运动员脚”进行了搜索。搜索策略包括所有临床试验,在过去的10年中,以英语发表的观察性研究和评论。
■足癣最常见的是红色毛癣菌和毛癣菌。据估计,大约3%的世界人口患有足癣。青少年和成人的患病率高于儿童。高峰年龄发病率在16至45岁之间。足癣在男性中比女性更常见。家庭成员之间的传播是最常见的途径,和传播也可以通过间接接触受影响患者的受污染物品而发生。公认的足癣的三种主要临床形式:指间,角化过度(莫卡辛型)和囊泡(炎性)。足癣的临床诊断准确率较低。建议对病变活动边界的皮肤刮片进行KOH湿装检查,作为护理点测试。诊断是可以确认的,如有必要,通过真菌培养或不依赖于培养的分子工具进行皮肤刮片。浅表或局部足癣通常对局部抗真菌治疗有反应。口服抗真菌治疗应保留用于严重疾病,局部抗真菌治疗失败,同时存在甲癣或免疫功能低下的患者。
■局部抗真菌治疗(每天一次至两次,持续1-6周)是治疗浅表或局部足癣的主要方法。局部抗真菌剂的例子包括烯丙基胺(例如特比萘芬),唑类(如酮康唑),苄胺,环吡酮,Tolnaftate和amorolfine.用于治疗足癣的口服抗真菌药包括特比萘芬,伊曲康唑和氟康唑。局部和口服抗真菌药物联合治疗可提高治愈率。通过适当的抗真菌治疗预后良好。未治疗,病变可能持续并进展。
UNASSIGNED: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This
review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis.
UNASSIGNED: A search was conducted in April 2023 in PubMed Clinical Queries using the key terms \'tinea pedis\' OR \'athlete\'s foot\'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years.
UNASSIGNED: Tinea pedis is most often caused by Trichophyton rubrum and Trichophyton interdigitale. It is estimated that approximately 3% of the world population have tinea pedis. The prevalence is higher in adolescents and adults than in children. The peak age incidence is between 16 and 45 years of age. Tinea pedis is more common amongst males than females. Transmission amongst family members is the most common route, and transmission can also occur through indirect contact with contaminated belongings of the affected patient. Three main clinical forms of tinea pedis are recognized: interdigital, hyperkeratotic (moccasin-type) and
vesiculobullous (inflammatory). The accuracy of clinical diagnosis of tinea pedis is low. A KOH wet-mount examination of skin scrapings of the active border of the lesion is recommended as a point-of-care testing. The diagnosis can be confirmed, if necessary, by fungal culture or culture-independent molecular tools of skin scrapings. Superficial or localized tinea pedis usually responds to topical antifungal therapy. Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis or in immunocompromised patients.
UNASSIGNED: Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.