Korting H C, Schaller M
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstrasse 9-11, 80337 München.
Hautarzt. 2001 Feb;52(2):91-7. doi: 10.1007/s001050051271.
Not only have the systemic mycoses clearly increased in number but also mycoses of the skin are more common than presumed in the past. Today onychomycosis is found in up to 10% of human beings. Onychomycosis can compromise quality of life markedly. Common tinea pedis is one of the most important risk factors for erysipelas of the lower legs. The clinical presentation of oral candidosis in HIV-infected patients is changing; Candida dubliniensis has been identified as another important causative microorganism. Onychomycosis today in most cases can be cured using terbinafine or itraconazole. When choosing the ideal drug in a given case, both the benefit risk ratio and the benefit cost ratio have to be taken into account. Liposomally encapsulated amphotericin B represents a major breakthrough in the treatment of systemic mycoses or fever of unknown origin. The same applies to liposomally encapsulated econazole with respect to tinea pedis. In regard to the pathogenesis of Candida infections the family of secreted aspartic proteinases plays a major role as a virulence factor and possible future target for antimycotic treatment.
不仅系统性真菌病的数量明显增加，而且皮肤真菌病也比过去认为的更为常见。如今，高达10%的人患有甲癣。甲癣会显著影响生活质量。常见的足癣是小腿丹毒最重要的危险因素之一。HIV感染患者口腔念珠菌病的临床表现正在发生变化；都柏林念珠菌已被确认为另一种重要的致病微生物。如今，大多数情况下甲癣可以使用特比萘芬或伊曲康唑治愈。在特定病例中选择理想药物时，必须同时考虑效益风险比和效益成本比。脂质体包裹的两性霉素B是系统性真菌病或不明原因发热治疗的一项重大突破。脂质体包裹的益康唑治疗足癣也是如此。关于念珠菌感染的发病机制，分泌天冬氨酸蛋白酶家族作为一种毒力因子发挥着重要作用，并且可能成为未来抗真菌治疗的靶点。
