足癣患者治疗现状调查

目的了解中国足癣患者的治疗现状,加强临床医生对相关诊治指南推荐方案的认知和理解。方法中国医师协会皮肤科医师分会组织全国9家医院进行中国足癣患者治疗现状问卷调查。结果共收集到问卷690份,结果显示我国足癣患者大多数选择自行购买外用抗真菌药物治疗,最常选用的外用药物为咪唑类药物,往往以瘙痒和／或皮疹消失作为停止治疗的依据,治疗最长时间中位数为2周,在治疗足癣的疗程上显示出明显不足。足癣患者常合并甲真菌病等其他皮肤癣菌病,同时其家庭成员患病率也较高,在治疗足癣患者的同时,应积极治疗其合并的其他皮肤癣菌病,也应同时对患者家庭成员进行治疗。结论本研究对更加有针对性地制定合理足癣预防和治疗方案并加强患者宣教具有重要作用。     

儿童头癣33例临床分析

目的 观察姜堰地区儿童头癣流行病学、传播方式、病原菌及治疗结果.方法 对我科2006年8月～ 2013年5月诊治的33例儿童头癣病例进行总结分析.结果 33例儿童头癣中白癣24例、黑癣5例、脓癣4例;男19例、女14例;犬小孢子菌22例、紫色毛癣菌2例、须癣毛癣菌3例、断发毛癣菌3例、红色毛癣菌1例、石膏样小孢子菌2例.患者中有动物接触史的占42.42％ （14/33）.经口服特比萘芬或伊曲康唑6～8周,每日用硫磺皂洗头,局部外用萘替芬酮康唑乳膏均取得满意疗效.8周时治愈率分别为87.50％和88.24％,真菌清除率分别为100％和94.12％.结论 近年来本病增多的原因与喂养猫、犬等宠物有关,主要病原菌是亲动物的犬小孢子菌,经综合治疗,疗效满意.     

盐酸布替萘芬乳膏治疗体、股癣,手、足癣60例疗效观察

目的观察1%盐酸布替萘芬乳膏治疗60例浅部真菌病疗效。方法进行治疗前、后临床疗效和真菌疗效评价。结果临床疗效评价和真菌疗效评价,总有效率分别为96.67%和96.7%。结论1%盐酸布替萘芬乳膏治疗浅表真菌病疗效良好。     

特比萘芬短程口服加外用特比萘芬治疗中重度皮肤癣菌病的临床对照研究

目的为治疗中、重度皮肤癣菌病选择合适的方法。方法采用开放、随机对照的平行研究。将临床和真菌镜检确诊的中重度体、股癣和手、足癣患者随机分入A、B、C、D四组,A组口服特比萘芬片联合外用特比萘芬乳膏,疗程7d;B组常规口服特比萘芬片,疗程14d;C组常规外用特比萘芬乳膏,疗程14d;D组外用联苯苄唑乳膏,疗程4周。对各组的临床疗效、安全性、患者对治疗的满意度等进行分析。结果①真菌学疗效:停药后4周时A组手、足癣患者的真菌清除率最高为96.65%,与D组比较(65.00%)差异有显著性。②临床疗效:停药后2周和4周时A组手足癣患者的治愈率分别为93.33%和90.00%,与D组(68%、64%)比较差异有显著性。③患者满意度:在本研究的四组中,A组患者对疗效的满意度最高,与C组、D组比较差异有显著性;患者的综合满意度(包括对治疗费用、安全性等方面)A组最高,与C组、D组比较差异有显著性。D组患者对费用的接受程度最高,A组优于B组,有极显著的统计学差异。治疗结束后患者对安全性的接受程度四组间没有显著差异。结论特比萘芬口服加外用1周的“1 1”短程联合疗法治疗中、重度皮肤癣菌病的疗效高、疗程短、依从性好,患者满意度高。     

萘替芬酮康唑乳膏每日1次治疗足癣疗效观察

目的观察萘替芬酮康唑乳膏1次/d治疗足癣的效果与安全性。方法将参与试验的足癣患者随机分组,试验组每晚1次外用萘替芬酮康唑乳膏,对照组早晚各1次外用萘替芬酮康唑乳膏。连续用药4周,于治疗前,用药2周、4周及停药2周后分别进行症状和体征评分。结果治疗结束和停药2周时,两组的临床疗效无显著差异(P>0.05)。治疗2周时试验组和对照组的真菌清除率分别为78.6%和90.3%,有显著差异(P<0.05);治疗结束和停药2周时试验组的真菌清除率分别为92.9%和97.6%,对照组分别为94.4%和98.6%,均无显著差异(P>0.05)。结论萘替芬酮康唑乳膏1次/d治疗足癣疗效好,简便易行,安全性高。     

美浮特?皮肤抗菌液治疗部队足癣患者的疗效研究

目的：观察美浮特?皮肤抗菌液治疗足癣的的临床疗效和安全性。方法2014年7月,选取部队足癣患者212例入组接受治疗,其中解放军三军仪仗队（仪仗队组）108例,北京武警某部（武警组）104例。疗程：一般选用单次治疗,一次性浸泡2 h。对于部分伴有鳞屑角化或伴发水疱的足癣,可增加1～2次治疗,每次浸泡时长仍为2 h,使用间隔14 d。分别于首次使用皮肤抗菌液治疗后1周、2周、4周时进行观察、随访,并记录不良事件。对部分病例,在治疗6个月后观察足癣的复发率。结果最终完成治疗和随访的有效病例有206例（仪仗队组104例,武警组102例）。第4周随访,总有效率为95．6％（197／206）,其中痊愈率78．2％（161／206）、显效率17．5％（36／206）,总真菌学清除率为95．1％。其中,仪仗队组第4周总有效率96．1％（100／104）,痊愈81．7％（85／104）;武警组第4周总有效率95．1％（97／102）,痊愈率74．5％（76／102）。安全性：不良反应均表现为局部症状,如轻度疼痛（51／212）,均于治疗结束后即得到缓解;局部皮肤水肿（12／212）,治疗结束后2 h内均自行缓解。未发现全身性不良反应。复发率：治疗后6个月可随访的156例中,总复发率8．97％（14／156）,其中仪仗队组复发率3．06％（3／98）,武警组复发率为18．97％（11／58）。患者满意度评价,总满意度为95．32％。结论美浮特?皮肤抗菌液治疗足癣临床疗效显著、安全性好,尤其适用于治疗需求迫切,需要短时、便捷、快速起效治疗方法的足癣人群。     

面癣误诊1例

报道由须癣毛癣菌感染引起并被长期误诊的面癣1例。患者女,37岁,因"面部反复红斑、丘疹、水疱伴瘙痒半年"就诊。多次被误诊为单纯疱疹、脓疱疮、湿疹、皮肤感染、脂溢性皮炎及玫瑰痤疮等,先后应用抗病毒、抗感染和抗过敏治疗,皮损未能完全消退并逐渐扩大。再次就诊,真菌学直接镜检阳性,真菌培养为须癣毛癣菌。给予口服特比萘芬片、外用联苯苄唑乳膏治疗后痊愈。     

Achievement of complete mycological cure by topical antifungal agent NND-502 in guinea pig model of tinea pedis

We examined the therapeutic effect of a 1% cream preparation of NND-502, a novel topical antifungal agent, in a guinea pig tinea pedis model produced by infecting the plantar skin of guinea pigs with Trichophyton mentagrophytes. Animals developing tinea pedis were divided into two groups: an untreated control group and a treated group. In the latter group, after confirming infection had been established, the infected animals were topically treated with the NND-502 cream once daily for one week. The animals were reared in a clean environment free from exposure to exogenous dermatophytes. At one week (5 weeks post-infection), 6 weeks (10 weeks post-infection) and 16 weeks (20 weeks post-infection) after completion of the treatment, plantar skin samples were taken from a certain number of both groups of animals. The results demonstrated that all of the animals in the untreated control group and none of those in the treated group were culture-positive in this animal model of tinea pedis. The topical treatment with NND-502 achieved a mycological cure. Thus NND-502 can be considered a promising candidate as a new anti-dermatophytic agent for topical use.     

Epidemiology of Dermatophytoses in an Area South of Tehran,Iran

Dermatophyte infections have been considered to be a major public health problem in many parts of the world. The aim of this study was to identify the etiological and epidemiological factors of dermatophyte infections in an area south of Tehran. A total of 1254 patients suspected to have dermatophytic lesions were examined over a period of three years (1999-2001). Material collected from skin, hair, and nails was submitted to direct microscopic examination using KOH, cultured in Sabouraud dextrose agar and microscopically examined for colony morphology, in order to the identify the 169 dermatophytes isolated. The prevalence of dermatophytoses was 13.5% (95% CI: 11.7-15.5%). Their incidence was 10.6 per 100,000 person-years (95% CI: 8.5-13.2). Epiderophyton floccosum was the most frequent dermatophyte isolated (31.4%) followed by Trichophyton rubrum (18.3%), T. mentegrophytes (17.2%), T. violaceum (16.6%), Microsporum canis (6.5%), T. verrucosum (4.7%) and M. gypseum (4.1%). Epidermophytes floccosum was found to be the most common isolated dermatophyte in age groups 20-29 (30.2%). Tinea corporis (31.4%) was the most common type of infection, followed by tinea cruris (20.7%), tinea manuum (15.4%), tinea capitis (12.4%), tinea pedis (10.6%), tinea faciei (7.1%), and tinea unguium (2.4%). The frequency rate of all of the types of tinea was higher in males than in females. The anthrophilic species E. floccosum was the most common dermatophyte as a causative agent of tinea. The most prevalent fungal infection was tinea corporis caused by E. floccosum.     

Onychomycosis in Cali,Colombia

This study presents the epidemiological and mycological aspects of 299 patients with nail lesions who were referred to three diagnostic laboratories in the city of Cali. The diagnosis of mycoses was established through visualization of mycotic structures in a direct microscopic examination of skin scrapings and by isolation. Onychomycosis was found in 183 cases (61.2%), of which 141 were in toenails (44 in males and 97 in females), 38 in fingernails (9 males and 29 females), and 4 cases in toenails and fingernails simultaneously (all females). No statistically significant relation was found between sex and onychomycosis. Yeasts accounted for 40.7% of the mycoses, dermatophytes for 38%, nondermatophyte molds for 14% and the etiology was mixed in the remaining cases (7.3%). Candida albicans was the most commonly isolated yeast species; the most common dermatophyte was Trichophyton rubrum and Fusarium spp. and Scytalidium dimidiatum were the most common nondermatophytic molds. Them common fungi found in fingernails were yeasts; in toenails dermatophytes were more prevalent (chi2 with Yates' correction = 19.75, P= 0.000088). Yeasts were observed more frequently in females while dermatophytes were more common in males. The difference between these two etiologic groups was statistically significant (chi2 with Yates' correction = 7.43, P = 0.0064); no relation was observed according to age.