复方酮康唑软膏治疗浅部真菌病疗效观察

我院于１９９８年６月～１０月采用复方酮康唑软膏,即皮康王治疗手足癣和体、股癣４０例,疗效显著,现报告如下。临床资料病例选择：４０例患者均为本院门诊病人。其中男２８例,女１２例;年龄１５～５８岁,平均３８岁;病程最短５天,最长２０年。手足癣２５例,体、股癣１５例。所有病例均具有典型的临床表现。真菌直接镜检阳性;诊断明确,２周内未用过其它抗真菌药。用药方法皮康王涂于患处,每日２次连用２周,每周复诊１次,４周后判定疗效,治疗期间不使用其它抗真菌药物。疗效观察痊愈：皮损消退,真菌镜检阴性;未愈：皮损未完…     

2%硝酸舍他康唑软膏治疗浅部真菌病152例疗效观察

1临床资料 入选标准：①结合病史、体征及实验室检查，临床明确诊断的手足癣（不包括角化过度型）、体癣、股癣（不超过体表面积3％者）、花斑癣且真菌直接镜检阳性；②年龄16～65岁，男女不限；③3个月内未服抗真菌药物及2周内未外用抗真菌药物。排除标准：①对唑类药物有接触过敏者；②有严重心、肝、肾疾病或糖尿病；③局部合并有细菌感染或可能干扰诊治的其他皮肤病。共入选287例，男162例，女125例；年龄16～65岁，平均40．5岁，随机分为治疗组和对照组。治疗组152例，对照组135例。两组在性别、年龄、皮损严重程度方面均无显著性差异（P均〈0．05）。     

萎缩性花斑糠疹

患者女,26岁。因胸腹部鳞屑性红斑伴萎缩近2年就诊。取皮屑直接镜检,见较多粗短的菌丝及成簇孢子。皮损组织病理检查,过碘酸雪夫（PAS）染色见角质层内较多菌丝和孢子。弹力纤维染色示弹力纤维减少,部分弹力纤维纤细、断裂。诊断：萎缩性花斑糠疹。治疗：口服伊曲康唑胶囊200mg/d共1周,外用2%舍他康唑乳膏4周,皮疹消退,真菌直接镜检复查阴性。     

孚琪治疗浅部真菌病的临床分析

我科于 2 0 0 0年 3～ 9月用孚琪 (北京四环制药厂生产 )治疗 15 0例手足癣、体股癣及皮肤念珠菌病的患者并随访观察 ,取得满意疗效 ,现报道如下。病例选择　所有病例均为门诊患者 ,有典型的临床表现 ,且真菌镜检呈阳性。其中手足癣、体股癣患者镜检可查到真菌菌丝 ,皮肤念珠菌患者查到大量假菌丝和孢子。手足癣 5 0例 ,18%的患者合并有股癣。体股癣患者 80例 ,32 .5 %的患者曾经使用皮炎平或其它皮质类固醇制剂而导致皮损扩散。皮肤念珠菌感染的患者 2 0例均为 4个月～ 1岁的儿童 ,其中6 2 %是在感冒后长期应用广谱抗生素后发生的 ,并且于…     

南昌地区浅部真菌分布调查分析

我们对２００１年在我院门诊就诊的浅部真菌病患者进行了真菌培养及菌种鉴定，以进一步观察了解南昌地区浅部真菌的分布情况。所有病例均来自２００１年１月～１２月我院门诊就诊的患者。临床诊断的手足癣、体股癣、甲真菌病、头癣、念珠菌性外阴龟头炎。皮损处真菌直接镜检必须是阳性。患者年龄性别不限，且就诊两周前未接受过全身抗真菌治疗。采用本院自制的沙堡培养基，温度为２７℃，湿度为８２±２％，培养１～２周。１０９６例浅部真菌病患者中手足癣２８７例，体股癣４６７例，甲真菌病８６例，头癣５１例，念珠菌外阴龟头炎２０５例…     

环利软膏治疗浅部真菌病疗效观察

环利软膏 (1%环吡酮胺 )是一种非咪唑类广谱抗真菌药 ,是吡啶酮的衍生物。我科于 2 0 0 0年 3～ 6月用北京第六制药厂生产的环利软膏治疗体股癣、手足癣、花斑癣共 30例 ,现将观察结果报告如下 :1　材料与方法1 1　病例选择入选标准 :具有典型临床症状和体征的体股癣、手足癣、花斑癣 ,真菌镜检阳性 ,1周内未外用抗真菌药物和 1月内未口服抗真菌药物。剔除标准 :妊娠及哺乳期妇女 ;用药部位合并细菌感染者 ;对环吡酮胺过敏者 ;不能坚持复诊 ,中断疗程者。1 2　入选病例　 30例有效入选病例均为本院皮肤科门诊病人 ,其中女性 17例 ,男性 13例…     

派瑞松霜治疗浅部真菌病40例疗效观察

1998年 3月～ 12月 ,我科应用西安杨森制药有限公司生产的派瑞松霜 (原名复方达克宁霜 )治疗浅部真菌病 40例 ,获得满意效果 ,现总结如下。临床资料　接受治疗的均为我科门诊患者 ,年龄 8～ 69岁。男 2 4例 ,女 16例 ,病程 7天～ 2 5年。其中体癣 12例 ,股癣 8例 ,花斑癣 6例 ,手足癣 4例 ,擦烂型念珠菌病 10例 ,真菌直接镜检阳性 ,近 1月内未用过任何抗真菌药物。治疗方法　外搽派瑞松霜每日 2次连用 3周。疗效判定标准　在治疗后第 2、3周评定疗效。痊愈为皮损完全消退 ,自觉症状消失 ,真菌直接镜检及培养阴性 ;显效为皮损消退 60 %以上 ,…     

1％益康唑和0.1％曲安奈德霜治疗皮肤真菌病的疗效观察

我们观察了派瑞松霜（１%硝酸益康唑加０．１%曲安奈德霜剂）治疗皮肤真菌病的疗效、耐受性及不良反应,现报道如下。一、病例和方法（一）病例选择:①病例入选标准:轻度到中度炎症性的真菌感染皮肤病（或伴有细菌感染）;不同年龄、性别均可;有典型的临床表现,经真菌直接镜检为阳性,并做真菌培养。病种包括:体癣、股癣、手癣（除角化型的手足癣）、足癣及皮肤念珠菌病;口头同意接受本研究者。②不入选标准:用药前２周内,外用皮质类固醇或其它抗细菌、抗真菌药物治疗者;用药前４周内,全身应用皮质类固醇或其它抗细菌、抗真菌药物治疗者;对研究…     

昆明地区3 524例浅部真菌感染病原学分析

目的了解昆明地区浅部致病真菌的实验室诊断与临床诊断的符合度、病种分布及病原学,为临床更好诊治浅部真菌感染提供参考。方法对昆明医科大学第一附属医院皮肤科2018年1月到2019年12月拟诊为浅部真菌病的病例进行临床资料、真菌镜检及培养结果统计和分析。结果 12 796例拟诊病例通过真菌直接镜检和培养结果分析,确诊浅部真菌感染3 524例,其中足癣833例(23.63%),手癣663例(18.81%),体癣517例(14.67%),股癣221例(6.27%),甲真菌病583例(16.54%),头癣457例(12.97%),花斑糠疹和马拉色菌毛囊炎250例(7.09%)。真菌直接镜检阳性3 381例,培养阳性1 755例,鉴定结果红色毛癣菌989株(56.35%),糠秕孢子菌558株(31.79%),酵母菌199株(11.34%),其他真菌9株(0.52%)。结论体股癣、手足癣、甲真菌病是昆明地区浅部真菌病主要病种,红色毛癣菌、糠秕孢子菌、酵母菌是主要的病原菌。     

65751例真菌病患者病种及其致病菌种分析

目的：明确我院就诊患者中真菌病种及其致病菌种的分布。方法：对我院皮肤性病门诊2012年4月-2016年8月拟诊为真菌感染的65751例患者中真菌检查阳性的患者临床资料及分离的致病菌株资料进行回顾性分析。结果：65751例中直接镜检和（或）培养阳性22855例,阳性率35%。 共包括11个病种,患病人数前三位的病种为足癣5054例,甲真菌病3866例,股癣3071例。共分离出致病真菌5884株,前三位为红色毛癣菌3794株（64.46%）,念珠菌943株（16.03%）,第三是须癣毛癣菌558株（9.48%）。结论：我院真菌病患者中足癣、甲真菌病和股癣是最重要的病种,常见菌种为兼顾毛癣菌和念珠菌。     

Wood灯在皮肤浅表真菌感染诊断中应用价值评估

目的 评估Wood灯在皮肤常见浅表真菌感染诊断中的应用价值.方法 对129例根据临床病史及体征初步诊断为皮肤浅表真菌感染患者进行Wood灯和真菌实验室检查.结果 花斑糠疹、马拉色菌毛囊炎患者Wood灯检查的阳性率分别为84%、85.7%,同时阳性病例的真菌培养或镜检的阳性率达92.9%、87.5%,两者有高度的一致性.而临床诊断手足癣和体股癣者其荧光阳性率只有8.3%.真菌总检出率却高达85.4%(41/48),两者不具有一致性.结论 Wood灯在花斑糠疹、马拉色菌毛囊炎的检查上有较高的特异性和敏感性,临床诊断上有应用价值,而对手足癣和体股癣诊断则无意义.

Abstract：

Objective To estimate the performance of Wood's lamp examination in the diagnosis of superficial cutaneous fungal infections. Methods Totally, 129 patients, who were diagnosed with superficial cutaneous fungal infections according to clinical medical history and signs, were enrolled in this study. Wood's lamp examination of lesions was carried out. Cutaneous samples were obtained from the patients and subjected to microscopic examination and fungal culture. Results Wood's lamp examination was positive in 84% and 85.7% of patients with tinea versicolor and malassezia folliculitis, respectively; among these patients positive for Wood's lamp examination, 92.9% were positive for fungal culture, and 87.5% for microscopic examination. In patients clinically diagnosed with tinea manus and pedis, tinea corporis or tinea cruris, 8.3% were positive for Wood's lamp examination, while 85.4% were positive for fungal examination. There was a high consistency between Wood's lamp examination and fungal examination in patients with tinea versicolor and malassezia folliculitis, but not in those with tinea manus and pedis, tinea corporis or tinea cruris. Conclusions Wood's lamp examination shows a high specificity and sensitivity and is useful in the diagnosis of tinea versicolor and malassezia folliculitis, but seems unapplicable for the diagnosis of tinea manus and pedis, tinea corporis or tinea cruris.     

浅部真菌病2600例病原菌分析

目的了解昆明地区浅部致病真菌的分布情况。方法对本科2010年1月-2011年6月拟诊为浅部真菌病患者的临床标本再次进行镜检和分离培养及菌种鉴定,并对结果进行统计学分析。结果 7944份临床送验标本中,直接涂片镜检阳性率29.39%,培养阳性率19.70%,而镜检和(或)培养的阳性率为32.73%,显著高于单一的镜检或培养。上述3种方法的真菌检出率差异均有统计学意义(P均<0.005)。分离的1565株浅部致病真菌中,红色毛癣菌1088株(69.52%),马拉色菌216株(13.80%),须癣毛癣菌118株(7.54%)。镜检和(或)培养阳性的2600例浅部真菌病患者中,足癣803例(30.88%),甲真菌病424例(16.31%),股癣386例(14.85%),体癣364例(14.00%),花斑癣259例(9.96%),手癣194例(7.46%),马拉色菌毛囊炎83例(3.19%)和头癣46例(1.77%),同时患有手癣和足癣41例(1.58%)。结论镜检结合培养法的阳性率显著高于单一镜检或培养法,昆明地区浅部真菌的病种以足癣、甲真菌病、股癣较多见,浅部致病真菌以红色毛癣菌和马拉色菌为主。     

复方联苯苄唑液治疗浅部真菌病双盲对照研究

目的 为了研究复方联苯苄唑液对浅部真菌病的疗效。方法 采用双盲对照的方法。试验组为复方联苯苄唑液,对照组为克霉唑癣药水。均每日涂患部1次,疗程体股癣为2周,手足癣为4周,停药后随访2周,主要观察红斑、丘疹、水疱、鳞屑、角化和瘙痒,评价治疗后每周的皮损情况。每例患者于疗前、疗中及疗后,停药后2周作真菌学检查。结果 观察434例患者,复方联苯苄唑液临床治愈率体股癣为82.25%,手足癣为68.75%,总有效率体股癣为95.85%,手足癣为92.5%;对照组治疗体股癣痊愈率为58.6%,手足癣为44.7%,有效率体股癣为83.0%,手足癣为87.2%。临床350株常见致病菌,复方联苯苄唑液的MIC为1.6~12.5mg/L,克霉唑药水的MIC为3.125~25mg/L。结论 复方联苯苄唑液是高效、广谱的抗真菌药物。本药能溶解、松解角质,渗透性好,可长期应用。     

利拉萘酯乳膏治疗手足癣和体股癣40例疗效观察

目的：评价2％利拉萘酯乳膏手足癣与体股癣的临床疗效及安全性，并与l％联苯苄唑乳膏进行比较。方法：对74例浅部真菌病患者进行治疗，其中治疗组40例，外用2％利拉萘酯乳膏，每日1次；对照组34例，外用1％联苯苄唑乳膏，每日1次。手足癣疗程4周，体股癣疗程2周。分别于停药及停药后2周观察患者的临床表现及治疗效果。结果：2％利拉萘酯乳膏和1％联苯苄唑乳膏临床疗效相似，停药时临床总有效率分别为87．50％和85．29％；停药后2周临床总有效率分别为97．50％和91．17％，两组总有效率比较差异均无统计学意义（P均〉0．05），无不良反应。结论：2％利拉萘酯乳膏治疗手足癣和体股癣使用方便，依从性好，安全，有效，是值得推广的一种新型外用抗真菌药。     

Efficacy and safety of terbinafine 1% solution in the treatment of interdigital tinea pedis and tinea corporis or tinea cruris

Two randomized, double-blind, vehicle-controlled, multicenter studies assessed the efficacy and safety of a new terbinafine 1% solution for the treatment of interdigital tinea pedis and tinea corporis or tinea cruris (tinea corporis/cruris). Patients with interdigital tinea pedis applied terbinafine 1% solution or vehicle twice daily for 1 week with 7 weeks of follow-up (N = 153), and patients with tinea corporis/cruris applied terbinafine 1% solution or vehicle once daily for 1 week with 3 weeks of follow-up (N = 66). Efficacy was assessed mycologically and clinically at the end of treatment and throughout follow-up. In the tinea pedis study, 66% of patients were effectively treated with terbinafine compared with 4% of the group treated by vehicle (P < .001; Mantel-Haenszel test). In the tinea corporis/cruris study, treatment was effective in 65% of the terbinafine group compared with 8% of the vehicle group (P < .001). There were no significant differences in the frequency of cutaneous adverse events between the 2 groups in either study. We conclude that one week of therapy with terbinafine 1% solution is highly effective, superior to vehicle, and safe for use in superficial fungal infections.     

The use of itraconazole to treat cutaneous fungal infections in children

BACKGROUND: Cutaneous mycoses such as tinea capitis, onychomycosis and some cases of tinea corporis/cruris, and tinea pedis/manus require oral antifungal therapy. There is relatively limited data regarding the use of the newer oral antifungal agents, e.g. itraconazole, in the treatment of these mycoses in children. OBJECTIVE: We wished to determine the efficacy and safety of itraconazole continuous therapy in the management of cutaneous fungal infections in children. METHODS: Children with cutaneous mycoses were treated with itraconazole in an open-label manner in 4 studies. For tinea capitis, the treatment regimens using itraconazole continuous therapy were: study 1, 3 mg/kg/day for 4 or 8 weeks; study 2, 5 mg/kg/day for 6 weeks, and study 3, 5 mg/kg/ day for 4 weeks. In a different trial, study 4, itraconazole continuous therapy 5 mg/kg/day was used to treat toenail onychomycosis (duration: 12 weeks), tinea corporis/ cruris (duration: 1 week) and tinea pedis/manus (duration: 2 weeks). RESULTS: The efficacy rates at follow-up 12 weeks from the start of therapy in children with tinea capitis treated using the itraconazole continuous regimen were: clinical cure (CC) and mycological cure (MC) in study 1 (n = 10, Trichophyton violaceum all patients), CC 50%, MC 86%; in study 2 (n = 35, Microsporum canis 22 patients, Trichophyton sp. 12 patients), CC 82.8%, MC 80%, and in study 3 (n = 16, M. canis 11 patients, Trichophyton sp. 5 patients), (CC 66.7%, MC 78.5%. Itraconazole was also effective in the treatment of dermatomycoses in 24 children (study 4). The CC and MC rates at the follow-up 8 weeks from the start of therapy in children with dermatomycoses and 12 months in children treated for onychomycosis were: onychomycosis (n = 1, T. rubrum), CC 100%, MC 100%; tinea corporis (n = 12, M. canis 10 patients), CC 100%, MC 90%; tinea cruris (n = 3, Trichophyton sp. 2 patients), CC 100%, MC 100%; tinea manus (n = 1, T. rubrum), CC 100%, MC 100%, and tinea pedis (n = 7, T. rubrum), CC 100%, MC 100%). Adverse effects consisted of a cutaneous eruption in 1 (1.2%) of the 85 children, with mild, transient, asymptomatic elevation of liver function tests (less than twice the upper limit of normal) in 2 (3.4%) of 58 children in whom monitoring was performed. CONCLUSIONS: Itraconazole is effective and safe in the treatment of tinea capitis and other cutaneous fungal infections in children.     

利拉萘酯乳膏治疗体股癣及足癣的多中心随机双盲对照观察

目的 探讨2%利拉萘酯乳膏治疗体股癣、足癣的临床疗效和安全性。方法 采用多中心随机双盲阳性药平行对照法，分别在3个中心进行，入选288例患者，2%利拉萘酯乳膏试验组144例，1% 联苯苄唑乳膏对照组144例；每组中体股癣患者各72例，足癣患者各72例。每日涂药1次，足癣疗程4周，每2周复诊1次；体股癣疗程2周，每周复诊1次；停药后2周均再复诊1次。结果 试验组体股癣患者中有１例脱落。停药时体股癣试验组的痊愈率和有效率分别为59.2%和94.4%，足癣试验组分别为41.7%和81.9%，与对照组比较，差异均无统计学意义（P ＞ 0.05）。在用药结束后2周时，体股癣试验组的痊愈率和有效率分别为67.6%和94.4%，足癣试验组分别为54.2%和81.9%，与对照组比较，差异无统计学意义（P ＞ 0.05）。在用药结束后2周，体股癣和足癣试验组符合方案分析集真菌学清除率分别为97.18%和90.28%，试验组和对照组差异均无统计学意义（P ＞ 0.05）。用药后发生的不良反应表现为用药部位红肿、疼痛，其中体股癣试验组不良反应发生率为2.78%。结论 2%利拉萘酯乳膏治疗体股癣、足癣有良好的疗效和安全性。     

1%环吡酮胺软膏治疗浅部真菌病的疗效观察

目的 :评价环吡酮胺软膏治疗皮肤浅部真菌病的疗效和安全性。方法 :1 3 0例浅部真菌病分成二组 ,治疗组外用环吡酮胺软膏 ,对照组外用特比萘芬乳霜 ,体股癣疗程 2周 ,手足癣疗程 4周。结果 :治疗组 66例中治愈 42例 ,显效 1 8例 ,临床总有效率 90 91 % ,真菌清除率 89 3 9% ;对照组总有效率为 92 1 9% ,真菌清除率为 90 63 % ,两组疗效差异无显著性 (P >0 0 5 )。结论 :环吡酮胺软膏治疗皮肤浅部真菌病疗效显著且安全     

美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病疗效观察

目的评价美克(1%联苯苄唑乳膏)治疗体股癣、手足癣、花斑癣和皮肤念珠菌病的临床疗效和安全性。方法采用多中心、随机、平行对照的方法,试验组外用美克,对照组外用欣欣(1%盐酸布替萘芬乳膏)。结果体股癣患者停药时试验组与对照组痊愈率分别为42.20%和39.45%,有效率分别为94.49%和91.74%;停药2w时,试验组与对照组痊愈率分别为85.32%和82.56%,有效率分别为97.24%和96.33%。手足癣停药时试验组与对照组痊愈率分别为39.87%和37.34%,有效率分别为85.54%和84.81%;停药2w时,试验组与对照组痊愈率分别为59.49%和58.22%,有效率分别为89.24%和86.70%。花斑癣患者停药时试验组与对照组痊愈率分别为50.72%和52.17%,有效率分别为79.71%和76.81%;停药2w时,试验组与对照组痊愈率分别为66.67%和63.76%,有效率分别为84.05%和81.16%。皮肤念珠菌病患者停药时试验组与对照组痊愈率分别为34.88%和39.53%,有效率分别为72.09%和76.74%;停药2w时,试验组与对照组痊愈率分别为65.11%和67.44%,有效率分别为88.37%和86.04%。局部不良反应发生率各试验组合计为5.27%;各对照组合计为5.54%。上述各项指标,各病种试验组与对照组比较差异均无统计学意义。结论美克治疗体股癣、手足癣、花斑癣和皮肤念珠菌病安全有效。     

Short treatment schedules of itraconazole in dermatophytosis

Patients were recruited from 1 December 1994 until 31 August 1995. Those presenting with tinea cruris/corporis received 200 mg of itraconazole every day for 7 days, whereas patients presenting with tinea pedis/manus were treated with 200 mg twice a day for 7 days. Those eligible were men and women at least 18 years of age, with a clinically diagnosed dermatophytosis, confirmed by KOH examination and culture. Pregnant or nursing patients and those who did not use adequate birth control methods were excluded. Patients with a known history of chronic liver disease or other concomitant serious disease were also excluded. Patients who had received any oral antifungal or corticosteroid therapy within 30 days before enrollment or any topical antifungal or corticosteroid treatment within a week before enrollment were not eligible.
Clinical and mycologic (KOH and culture) evaluation was carried out at baseline, at completion of therapy (day 7) and at the end of follow-up (day 28 for tinea cruris/corporis and day 35 for tinea pedis/manus). The investigator evaluated the following clinical symptoms at each visit: desquamation, erythema, infiltration, pruritus, exudation, maceration, vesiculation, and pustules. Clinical results were rated as: healed, markedly improved, considerable residual lesions, not changed, or worse. The categories healed and markedly improved were considered as responders.
All mycology was performed centrally at the Department of Microbiology, University of Malaya.