Department of Dermatology and Venereology.
Department of Medical Microbiology.
Curr Opin Infect Dis. 2020 Apr;33(2):130-136. doi: 10.1097/QCO.0000000000000630.
This review aims to update on recent findings about epidemiology, risk factors and therapeutic options for fungi causing skin and soft tissue infections. The latest data on emerging antifungal resistance are also discussed.
In parallel with increased use of immunosuppression, the incidence of fungal infections is also on rise. This increase involves not only systemic infections but also infections with primary and secondary skin involvement. Antifungal resistance has become a major issue and covers several fungal pathogens including dermatophytes, Candida spp. and, Aspergillus fumigatus. Multidisciplinary usage of newly targeted, immunomodulatory therapies may predispose patients to have fungal infections through mimicking an immunosuppressed status caused by genetic factors or the disease itself. Nonimmunosupressed patients, although less frequently than those with immunosuppression may also be vulnerable.
Physicians should be aware about skin and soft tissue findings related with systemic or locally occuring mycosis. Emerging antifungal resistance may hamper the success of the treatment. Antifungal susceptibility testing is advisable wherever available and particularly when a disseminated fungal infection is present.
本综述旨在更新关于引起皮肤和软组织感染的真菌的流行病学、危险因素和治疗选择的最新发现。还讨论了最新的抗真菌耐药数据。
随着免疫抑制的广泛应用,真菌感染的发病率也在上升。这种增加不仅涉及系统性感染,还涉及原发性和继发性皮肤受累的感染。抗真菌耐药性已成为一个主要问题,涵盖了几种真菌病原体,包括皮肤癣菌、念珠菌属和烟曲霉。新靶向免疫调节疗法的多学科应用可能通过模拟由遗传因素或疾病本身引起的免疫抑制状态,使患者易患真菌感染。非免疫抑制患者,尽管比免疫抑制患者少见,但也可能易患感染。
医生应注意与系统性或局部真菌感染相关的皮肤和软组织表现。新兴的抗真菌耐药性可能会影响治疗的成功。只要有可能,特别是当存在播散性真菌感染时,建议进行抗真菌药敏试验。