伊曲康唑治疗儿童头癣18例临床观察

我科从 1997年 1月～ 2 0 0 0年 12月应用伊曲康唑治疗儿童头癣 ,获得满意疗效 ,现将按期复诊观察的 18例总结如下。1　资料与方法1.1　一般资料　所有患儿均来自我科门诊 ,随机将其分为治疗组和对照组。治疗组 18例 ,男 11例 ,女 7例 ;年龄 5～12岁 ,平均 9.6岁 ;病程 5周～ 1年 ;其中白癣 11例 ,黑癣 3例 ,脓癣 4例。对照组 8例 ,男 5例 ,女 3例 ;年龄 8～ 12岁 ,平均 10 .8岁 ;病程 4周～ 1年。其中白癣 5例 ,黑癣 2例 ,脓癣 1例。皮损0 .5ｃｍ× 1ｃｍ～ 6ｃｍ× 7ｃｍ ,数目 1～ 6个不等。全部患儿 3个月内未外用或口服抗真菌药物 ,患…     

伊曲康唑治疗头癣的疗效观察

目的：了解伊曲康唑治疗儿童头癣的疗效和安全性。方法：头癣患儿每天晚饭后一次口服100mg伊曲康唑,连续6周。结果：治疗第7周,25例患中治愈2例,显效9例,临床总有效率84％。治疗第14周痊愈19例（76％）,显效4例,总有效率92％。真菌学清除率为100％。未见明显的不良反应。结论：伊曲康唑治疗儿童头癣疗效高、安全。     

伊曲康唑治疗头癣效果的系统评价

检索了Cochrane Library，Medline，EMBASE，中国生物医学数据库，手检《中华皮肤科杂志》，《临床皮肤科杂志》，《中国麻风皮肤病杂志》，《中国皮肤性病学杂志》，检索的最近日期至2003年12月。比较伊曲康唑与其他抗真菌药治疗头癣的效果和安全性。最终3个随机对照试验完全符合本系统评价的纳入标准，对照措施包括灰黄霉素，特比萘芬，氟康唑。纳入研究的样本含量从35例到200例。结论：伊曲康唑治疗头癣效果与灰黄霉素，特比萘芬，氟康唑相当，且副作用小于灰黄霉素。     

伊曲康唑治疗儿童头癣48例

儿童头癣患者在逐渐增多,我院皮肤性病科门诊于2000年1月。2003年10月,应用伊曲康唑治疗儿童头癣48例,取得满意疗效,现将结果报告如下。     

伊曲康唑冲击疗法治疗头癣46例临床观察

伊曲康唑(商品名斯匹仁诺,西安杨森制药有限公司生产)是三氮唑类广谱　河南开封市第二人民医院,475002抗真菌药。自1996年以来我院用伊曲康唑冲击疗法治疗儿童头癣取得了满意疗效。现报告如下。临床资料　46例为1996年～1998年我院门诊病人,年龄3～14岁,具有典型的头癣临床表现,真菌学镜检及(或)真菌学培养阳性,1个月内未用过口服或外用抗真菌药物。病程2周～10月。其中白癣29例,黄癣3例,黑点癣7例,脓癣7例。真菌培养结果许兰黄癣菌3例,铁锈色小孢子菌5例,断发毛癣菌7例,犬小孢子菌18例,红色毛癣菌11例,紫色毛癣菌及须癣毛癣菌各1例。患者治…     

伊曲康唑治疗花斑癣50例临床观察

１９９９年４～１０月,我们应用伊曲康唑治疗花斑癣患者５０例,获得较好效果,现报告如下。１临床资料 选择门诊１８～６５岁之间,经真菌直接镜检阳性患者５０例。病例入选标准：３月内未接受过全身抗真菌药物治疗,１月内未接受过外用抗真菌药物治疗者;无肝、肾、血液及胃肠道疾病者。５０例病人中男 ３３例,女 １７例。年龄：＜ ２０岁 ８例, ２０～ ４０岁 ３５例,＞ ４０岁 ７例,平均 ３０．６８岁。病程：＜１年 １５例, １～５年 ３０例,＞ ５年 ５例,平均 ２． ９９年。皮损面积：＜５％２４例,５％－１０％１６例,＞１…     

成人头癣26例临床及治疗分析

报告26例头癣的临床和治疗情况。26例患者白癣16例,脓癣8例,黑点癣2例。所有患者均采用伊曲康唑治疗,200mg/d,连服3周。结果26例患者在停药2周后真菌镜检及培养均阴性。     

伊曲康唑治疗儿童头癣36例临床观察

目的：观察伊曲康唑对儿童头癣的疗效及安全性。方法：口服伊曲康唑100mg每日1次，连服6周。结果：36例患儿完成疗程时痊愈25例，显效8例；停药4周后，痊愈31例，显效3例，总有效率94.4%。结论：伊曲康唑治疗儿童头癣疗效显。     

伊曲康唑治疗股癣疗效观察

笔者于2004年5月～2005年5月用伊曲康唑（商品名：美扶，天津力生制药股份有限公司生产）治疗股癣60例，取得较好疗效。现将结果报告如下。     

伊曲康唑治疗儿童头癣七例

我们使用伊曲康唑治疗儿童头癣,取得较好疗效,现报道如下.     

Treatment of tinea capitis with itraconazole

This trial examined tiie use of itraconazole in patients with tinea capitis who were eitiier unresponsive to or unable to tolerate griseofulvin therapy. An estimated 800 patients from muitipie counties throughout Ohio were seen by this clinic for the treatment of tinea capitis from 1992 to 1995. Patients were referred by dermatologists, pediatricians, or primary care physicians, or sought treatment on their own. Of these 800 patients, 659 had cultures performed at our ciinic; computer records were maintained for aii these patients. The remaining patients had cultures taken elsewhere and computer records were not maintained. Of the totai complement of patients, 120 had a previous unsuccessful trial with griseofuivin (liquid suspension or ultramicronized) and were either intolerant or nonresponsive and desired alternative therapy. Many of these patients had a history of an eruption while on griseofuivin therapy. It was unclear if this was an id or hypersensitivity reaction as opposed to a true aiiergy, but the patients refused further therapy. Other reasons for griseofuivin intoierance or nonresponsiveness were nausea, headache, photosensitivity, drug interactions, and simply patient exasperation with months of oral antifungal drug therapy. Failure to comply with hygienic measures and low dosage regimens also may have contributed to the high number of patients who were nonresponsive to griseofulvin. One hundred and twenty patients were treated with oral itraconazoie. Subjects ranged in age from 2.5 years to adult, with the majority of patients failing between the ages of 5 and 12 years. Most of those treated were black, with men and women approximately equally represented. All but one patient cultured positive for Trichophyton tonsurans; the remaining patient cultured positive for Microsporum canis. Patients were treated with itraconazole capsules for 30 days and dosage was proportioned to body weight, calculated at 3–5 mg/kg per day. Patients were told to take their medication with food or a cola beverage on the schedule given in Table 1. Patients were also instructed to apply ketoconazole 2% shampoo, left on for 5 min, two to three times a week, in addition to the itraconazole regimen. Other family members were also instructed to use ketoconazole shampoo two to three times a week. If insurance practices allowed, patients were evaluated at baseline, after 2 weeks of therapy, on completion of therapy (30 days), and at 4 weeks post-therapy. Cultures were performed at baseline and at the final visit. The patient's condition was evaluated at the second visit; if significant inflammation was still present, the dosage was increased to the next weight category. Patients were advised to inform their physician if any adverse reactions occurred which might be related to the treatment. All patients showed clinical improvement, with a resolution of inflammation and some hair regrowth, at the completion of the 30-day regimen of itraconazole. All patients tested negative on culture, and their clinical appearance continued to improve after cessation of therapy. All patients were considered clinically cured at the final follow-up visit, patient with M. canis infection followed the regimen for only 21 days, and experienced another incidence of tinea capitis within 6 months of completing therapy. It was not determined if this was a relapse or a new infection. A second 30-day course of itraconazole was effective and no subsequent episode has been reported.     

Optimizing the therapeutic approach in tinea capitis of childhood with itraconazole

BACKGROUND: Tinea capitis is the most common dermatophytosis of childhood with increasing incidence. Whereas griseofulvin is considered by many as the mainstay of treatment, newer oral antifungal agents, including fluconazole, itraconazole and terbinafine have demonstrated higher efficacy, resulting in shorter treatment durations. OBJECTIVES: We aimed to determine the optimum regimen for the treatment of childhood tinea capitis with itraconazole. METHODS: A mycological culture outcome-dependent combination of a 28-day continuous and facultative additional 14-day courses with itraconazole was used in 42 children (20 girls; 22 boys) aged 12-140 months (mean 66) with tinea capitis due to Microsporum canis (n = 26) and Trichophyton violaceum (n = 16). The drug was given orally according to the patients' body weight (50 mg daily for < 20 kg; 100 mg daily for > or = 20 kg) over 4 weeks. Direct microscopy and fungal culture as a parameter for efficacy were repeated 2 weeks after termination of treatment. Assessment of efficacy was based on the evaluation of results from light microscopy and culture at 8 weeks after initiation of treatment, and in the case of a further positive mycological culture at 14 and 20 weeks, respectively. A positive fungal culture at these times resulted in an additional course for 2 weeks with the initially chosen itraconazole dosage. RESULTS: In 34 of 42 patients a single 4-week course of itraconazole resulted in a complete mycological cure of lesions as demonstrated by light microscopy and mycological culture. Four of 42 patients had to be treated by a second itraconazole course for 2 weeks, and four children received a third course of itraconazole for 2 weeks until all lesions showed negative direct microscopy and mycological culture. No abnormal haematological or biochemical results occurred. Apart from transient, completely reversible indigestion in two children, no side-effects were observed. CONCLUSIONS: A culture-based 28-day continuous therapeutic regimen plus facultative cultural outcome-dependent additional 14-day courses of a body weight-adapted dosage of itraconazole in tinea capitis due to M. canis and T. violaceum is discussed; this offers the advantage of an effective therapy with complete negative direct microscopy as well as negative cultural results, within a shorter active treatment period (cf. previous studies with continuous administration of itraconazole).     

43例头癣患者临床及真菌病原学研究

目的了解本地区头癣发病情况以及菌种分布情况。方法对43例真菌镜检阳性确诊头癣的患者进行真菌培养、鉴定。结果43例头癣中黑癣27例（62．8％）、脓癣12例（27．9％）、白癣3例（7％）、黄癣1例（2．3％）,致病真菌主要为紫色毛癣菌13株（30％）、犬小孢子菌12株（27．9％）、红色毛癣菌6株（14％）、许兰毛癣菌1株（2．3％）。结论头癣主要致病菌为紫色毛癣菌和犬小孢子菌。     

伊曲康唑4周疗法治疗儿童头癣128例临床疗效观察

目的：了解伊曲康唑治疗儿童头癣的疗效与安全性。方法：采用伊曲康唑治疗128例头癣患儿，4岁以上的剂量为100mg／d，4岁以下剂量为50mg／d，晚餐后服用，连续服用4周。结果：128例患儿在疗程结束后4周的痊愈率为80．47％。所有患儿服药期间均未出现不良反应。结论：伊曲康唑4周疗法治疗儿童头癣疗效确切，安全性好。     

Microsporum canis tinea capitis in an 8-month-old infant successfully treated with 2 weekly pulses of oral itraconazole

We report an 8-month-old girl with tinea capitis caused by Microsporum canis which was successfully treated with two pulses of oral itraconazole 50 mg/day, each of 1 week duration with an interval of 2 weeks. M. canis tinea capitis can be a difficult therapeutic problem in an infant, as the treatment is usually long, lasting up to 4-6 weeks with griseofulvin and 6-12 weeks with terbinafine, and the desire to provide a safe systemic therapy is particularly important. With an intermittent regimen the duration of treatment with active drug can be much shorter compared to continuous therapy. We found that itraconazole pulse therapy for M. canis tinea capitis was a safe and effective treatment in an infant.     

上海地区600例头癣病原菌分析

目的：了解近10年间上海地区头癣的发病情况及病原菌的分布情况。方法：采用回顾性分析方法对1993年1月-2002年12月在华山医院皮肤科门诊诊治的居住在上海的头癣患者进行分析。结果：600例头癣患者男268例，女332例；年龄20d～84岁；498例真菌培养阳性患者中，白癣325例(65．26％)、黑癣132例(26．5l％)、脓癣40例(8．03％、)、黄癣1例(0．20％)。主要病原菌为羊毛状小孢子菌，322株(64．66％)、紫色毛癣菌89株(17．87％)、断发毛癣菌45株(9．04％)。结论：上海地区头癣中白癣发病率占首位，羊毛状小孢子菌为主要致病菌。     

广州地区241例头癣及病原菌分布情况分析

目的 了解广州地区头癣及其病原菌分布情况。方法 对1997年2月至2010年8月在本院皮肤科诊治的241例头癣患者资料进行回顾性分析。结果 241例头癣患者中白癣179例占74.27%,脓癣34例占14.11%,黑点癣28例占11.62%,未发现黄癣。病原菌中犬小孢子菌182株占80.89%,紫色毛癣菌25株占11.11%,须毛癣菌10株占4.44%,断发毛癣菌3株占1.33%,红色毛癣菌2株占0.89%,石膏样小孢子菌2株占0.89%,疣状毛癣菌1株占0.44%。患者年龄段分层分析结果显示,主要感染人群为学龄前儿童占39.00%。结论 广州地区头癣中白癣所占比例最高;犬小孢子菌为头癣患者的主要致病菌;主要感染人群为学龄前儿童。     

伊曲康唑与特比萘芬治疗儿童头癣疗效观察

目的:寻找治疗儿童头癣有效、安全的方法。方法:应用伊曲康唑治疗儿童头癣27例,特比萘芬治疗儿童头癣25例,并作疗效与真菌清除率观察。结果两种药物在用药8周以上的总有效率无明显差异,但伊曲康唑于用药第4周与第6周时疗效存在显著性差异,而特比萘芬在用药第6周与第8周时疗效存在显著性差异。结论:伊曲康唑与特比萘芬对治疗儿童头癣都是有效安全的,但伊曲康唑疗程需达6周,而特比萘芬疗程需达8周;伊曲康唑6周时达到真菌清除;而特比萘芬需达8周。