背景:甲真菌病是一种常见的指甲真菌感染。
目的:该研究旨在提供评估的最新信息,诊断,和治疗甲癣。
方法:在临床查询中使用关键术语“甲癣”完成PubMed搜索。搜索于2019年5月进行。搜索策略包括荟萃分析,随机对照试验,临床试验,观察性研究,以及过去20年发表的评论。搜索仅限于英语文学。在www中使用关键术语“甲癣”搜索专利。freepatentsonline.com.
结果:甲真菌病是指指甲单位的真菌感染。大约90%的趾甲和75%的指甲甲癣是由皮肤癣菌引起的,尤其是毛癣菌和红色毛癣菌。临床表现包括指甲变色,甲下角化过度,甲状腺溶解症,还有甲癣.诊断可以通过氢氧化钾湿装制剂的直接显微镜检查来确认,用高碘酸希夫染色对修剪的受影响的指甲板进行组织病理学检查,真菌培养,或聚合酶链反应测定。在开始治疗方案之前,应考虑对甲癣进行实验室确认。目前,口服特比萘芬是首选治疗方法,其次是口服伊曲康唑。总的来说,对于轻度至中度甲癣,可以考虑局部单药治疗,当口服抗真菌药物禁忌使用或不能耐受时,局部单药治疗是一种治疗选择.还讨论了与甲癣管理有关的最新专利。
结论:口服抗真菌治疗有效,但显著的不利影响限制了它们的使用。虽然局部抗真菌治疗有最小的不良事件,它们不如口服抗真菌疗法有效,由于不良的指甲渗透。因此,需要探索更安全和更有效的治疗甲癣的更有效和/或替代治疗方式。
BACKGROUND: Onychomycosis is a common fungal infection of the nail.
OBJECTIVE: The study aimed to provide an update on the evaluation, diagnosis, and treatment of onychomycosis.
METHODS: A PubMed search was completed in Clinical Queries using the key term \"onychomycosis\". The search was conducted in May 2019. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. The search was restricted to English literature. Patents were searched using the key term \"onychomycosis\" in www.freepatentsonline.com.
RESULTS: 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. The diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide wet-mount preparation, histopathologic examination of the trimmed affected nail plate with a periodic-acid-Schiff stain, fungal culture, or polymerase chain reaction assays. Laboratory confirmation of onychomycosis before beginning a treatment regimen should be considered. Currently, oral terbinafine is the treatment of choice, followed by oral itraconazole. In general, topical monotherapy can be considered for mild to moderate onychomycosis and is a therapeutic option when oral antifungal agents are contraindicated or cannot be tolerated. Recent patents related to the management of onychomycosis are also discussed.
CONCLUSIONS: Oral antifungal therapies are effective, but significant adverse effects limit their use. Although topical antifungal therapies have minimal adverse events, they are less effective than oral antifungal therapies, due to poor nail penetration. Therefore, there is a need for exploring more effective and/or alternative treatment modalities for the treatment of onychomycosis which are safer and more effective.