Department of Dermatology, Postgraduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi 110001, India.
Department of Dermatology, Postgraduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi 110001, India.
Fungal Genet Biol. 2019 Nov;132:103255. doi: 10.1016/j.fgb.2019.103255. Epub 2019 Jul 19.
Dermatophytoses or tinea refers to superficial fungal infection of keratinized tissues. Although generally considered easy to treat, recalcitrant infections, presenting as extensive and difficult to treat tinea corporis and cruris, are on the rise in some parts of the world. The situation demands an understanding of the pharmacokinetic and pharmacodynamic properties of the available antifungals against dermatophytes and the possible contribution of drug resistance and other factors to the present scenario. In this review, we provide the readers a comprehensive account of the available literature on in-vitro and in-vivo resistance to clinically used antifungals among dermatophytes. We have also added, in brief, the relevant skin pharmacokinetics of important systemic drugs. The established and postulated mechanisms of drug resistance are discussed and aspects on lack of in vivo correlation of in vitro resistance are presented. Finally, the lacunae in our existing knowledge on the topic and the arenas for future research are highlighted.
皮肤真菌病或癣是指角蛋白组织的浅表真菌感染。尽管一般认为易于治疗，但在世界某些地区，顽固感染（表现为广泛且难以治疗的体癣和股癣）的发病率正在上升。这种情况需要了解现有抗真菌药物对皮肤真菌的药代动力学和药效学特性，以及耐药性和其他因素对当前情况的可能贡献。在这篇综述中，我们为读者提供了关于皮肤癣菌对临床使用的抗真菌药物的体外和体内耐药性的现有文献的综合描述。我们还简要介绍了重要全身药物的相关皮肤药代动力学。讨论了已建立和推测的耐药机制，并介绍了体外耐药与体内相关性缺乏的方面。最后，强调了我们在该主题现有知识中的空白以及未来研究的领域。
