Effendy I, Lecha M, Feuilhade de Chauvin M, Di Chiacchio N, Baran R
Hautklinik, Klinikum Rosenhöhe, Städtische Kliniken Bielefeld, An der Rosenhöhe 27, Bielefeld, Germany.
J Eur Acad Dermatol Venereol. 2005 Sep;19 Suppl 1:8-12. doi: 10.1111/j.1468-3083.2005.01281.x.
To review recent data - what is new in the epidemiology of onychomycoses? To identify the most relevant diagnostic criteria for effective therapy.
The preliminary results of the European Onychomycosis Observatory (EUROO) study were analysed. In this international study, physicians completed questionnaires concerning patient profile and the disease.
One of the most interesting novel findings was that sampling requests were often not made [only 3.4% of general physicians (GPs) and 39.6% of dermatologists]. This means that no information about causative agent(s) was available, hindering appropriate treatment choice. Furthermore, contrary to previous findings, 70.7% of participants did not practice sports. Lastly, these preliminary findings showed that treatment strategy depends largely on the type of treating physician, with GPs preferring monotherapy and dermatologists preferring combination therapy.
A consensus was reached that treatment strategy should depend on the severity of nail involvement and the causative fungus. It is thus important to promote the importance of sampling. To simplify the choice of an appropriate treatment, onychomycosis may be divided into just two clinical groups: onychomycosis with and without nail matrix area involvement. However, the distinct clinical findings (number and type of affected nails, multimorbidity, drug interaction, etc.) in each individual case must be taken into account to ensure an appropriate treatment decision.
回顾近期数据——甲真菌病流行病学中有哪些新情况？确定有效治疗的最相关诊断标准。
分析了欧洲甲真菌病观察站（EUROO）研究的初步结果。在这项国际研究中，医生填写了有关患者情况和疾病的问卷。
最有趣的新发现之一是，通常不进行取样（普通医生中只有3.4%，皮肤科医生中为39.6%）。这意味着没有关于病原体的信息，从而阻碍了恰当的治疗选择。此外，与之前的发现相反，70.7%的参与者不进行体育活动。最后，这些初步结果表明，治疗策略在很大程度上取决于治疗医生的类型，普通医生更喜欢单一疗法，而皮肤科医生更喜欢联合疗法。
达成的共识是，治疗策略应取决于指甲受累的严重程度和致病真菌。因此，宣传取样的重要性很重要。为了简化合适治疗方法的选择，甲真菌病可仅分为两个临床组：累及甲母质区的甲真菌病和未累及甲母质区的甲真菌病。然而，每个病例的独特临床发现（受累指甲的数量和类型以及多种疾病、药物相互作用等）都必须考虑在内，以确保做出恰当的治疗决策。
