Kakourou Talia, Uksal Umit
First Pediatric Department, Athens University, Aghia Sophia Children's Hospital, Athens, Greece.
Pediatr Dermatol. 2010 May-Jun;27(3):226-8. doi: 10.1111/j.1525-1470.2010.01137.x.
Practice guidelines for the treatment of tinea capitis (TC) from the European Society for Pediatric Dermatology are presented. Tinea capitis always requires systemic treatment because topical antifungal agents do not penetrate the hair follicle. Topical treatment is only used as adjuvant therapy to systemic antifungals. The newer oral antifungal agents including terbinafine, itraconazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may be, however, more expensive (Grading of recommendation A; strength of evidence 1a). Griseofulvin is still the treatment of choice for cases caused by Microsporum species. Its efficacy is superior to that of terbinafine (Grading of recommendation A; strength of evidence 1b), and although its efficacy and treatment duration is matched by fluconazole (Grading of recommendation A; strength of evidence 1b) and itraconazole (Grading of recommendation A; strength of evidence 1b), griseofulvin is cheaper. It must be noted, however, that griseofulvin is nowadays not available in certain European countries (e.g., Belgium, Greece, Portugal, and Turkey).
本文介绍了欧洲儿科皮肤病学会关于头癣（TC）治疗的实践指南。头癣总是需要进行全身治疗，因为外用抗真菌药物无法穿透毛囊。局部治疗仅用作全身抗真菌药物的辅助治疗。在由毛癣菌属引起的儿童头癣中，包括特比萘芬、伊曲康唑和氟康唑在内的新型口服抗真菌药物，其有效率和潜在不良反应似乎与灰黄霉素相似，但治疗时间要短得多。然而，它们可能更昂贵（推荐等级A；证据强度1a）。对于由小孢子菌属引起的病例，灰黄霉素仍然是首选治疗药物。其疗效优于特比萘芬（推荐等级A；证据强度1b），虽然其疗效和治疗时间与氟康唑（推荐等级A；证据强度1b）和伊曲康唑（推荐等级A；证据强度1b）相当，但灰黄霉素更便宜。然而，必须注意的是，如今在某些欧洲国家（如比利时、希腊、葡萄牙和土耳其）已无法获得灰黄霉素。
