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体癣:最新综述

Tinea corporis: an updated review.

作者信息

Leung Alexander Kc, Lam Joseph M, Leong Kin Fon, Hon Kam Lun

机构信息

Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.

Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Drugs Context. 2020 Jul 20;9. doi: 10.7573/dic.2020-5-6. eCollection 2020.

Abstract

BACKGROUND

Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment.

OBJECTIVE

This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis.

METHODS

A PubMed search was performed with Clinical Queries using the key term 'tinea corporis.' The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article.

RESULTS

Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient.

CONCLUSION

The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.

摘要

背景

体癣是一种常见的真菌感染,可模仿许多其他环形皮损。医生必须熟悉这种疾病及其治疗方法。

目的

本文旨在对体癣的评估、诊断和治疗进行叙述性的最新综述。

方法

使用关键词“体癣”在PubMed上进行临床查询搜索。搜索策略包括临床试验、荟萃分析、随机对照试验、观察性研究和综述。搜索仅限于英文文献。从上述搜索中检索到的信息用于编写本文。

结果

体癣通常表现为边界清晰、边缘锐利、椭圆形或圆形、轻度红斑、鳞屑性斑片或斑块,边缘隆起。轻度瘙痒很常见。诊断通常基于临床,但如果患者之前使用过钙调神经磷酸酶抑制剂或皮质类固醇等药物,诊断可能会有困难。皮肤镜检查是一种有用的非侵入性诊断工具。如有必要,可通过对病变活动边缘的皮肤刮屑进行氢氧化钾湿片显微镜检查来确诊。真菌培养是诊断皮肤癣菌病的金标准,特别是在诊断存疑且其他检查结果不确定或感染广泛、严重或对治疗耐药时。体癣的标准治疗方法是外用抗真菌药。如果皮损多发、广泛、深部、复发、慢性或对外用抗真菌治疗无反应,或患者免疫功能低下,则需进行系统性抗真菌治疗。

结论

体癣的诊断通常基于临床,如果皮损典型,对医生来说应该不成问题。然而,体癣存在许多临床变异型,尤其是在患者之前使用过钙调神经磷酸酶抑制剂或皮质类固醇等药物的情况下,会使诊断变得困难。因此,医生必须熟悉这种疾病,以便做出准确诊断并开始适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9d4/7375854/c4998f9d81f7/dic-2020-5-6-g001.jpg

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