Department of Dermatology, Faculty of Medicine, Başkent University Adana Hospital, Adana, Turkey.
Division of Mycology, Department of Microbiology, Faculty of Medicine, University of Çukurova, Adana, Turkey.
Expert Rev Anti Infect Ther. 2023 Jan;21(1):29-40. doi: 10.1080/14787210.2023.2144232. Epub 2022 Nov 8.
Significant problems are associated with the diagnosis and treatment of dermatophyte infections, which constitute the most common fungal infections of the skin. Although this is a common problem in the community, there are no adequate guidelines for the management of all forms of dermatophyte infections. Even if dermatophytes are correctly diagnosed, they sometimes exhibit poor susceptibility to several antifungal compounds. Therefore, long-term treatment may be needed, especially in immunosuppressed patients, for whom antifungal pharmacotherapy may be inconvenient owing to allergies and undesirable drug interaction-related effects.
In this review article, problems related to the diagnosis and treatment of dermatophyte infections have been discussed, and suggestions to resolve these problems have been presented.
Pretreatment microscopic or mycological examinations should be performed for dermatophyte infections. In treatment-refractory cases, antifungal-resistant strains should be determined using antifungal susceptibility testing or via molecular methods. Natural herbal, laser, and photodynamic treatments can be used as alternative treatments in patients who cannot tolerate topical and systemic antifungal treatments.
诊断和治疗皮肤癣菌感染存在重大问题,皮肤癣菌感染是最常见的真菌感染。尽管这是社区中的常见问题,但对于所有形式的皮肤癣菌感染,尚无足够的管理指南。即使正确诊断出皮肤癣菌,它们有时也表现出对几种抗真菌化合物的低敏感性。因此,可能需要长期治疗,特别是对于免疫功能低下的患者,由于过敏和不良药物相互作用相关的影响,抗真菌药物治疗可能会不方便。
在这篇综述文章中,讨论了与皮肤癣菌感染的诊断和治疗相关的问题,并提出了一些解决这些问题的建议。
对于皮肤癣菌感染,应进行治疗前的显微镜或真菌学检查。对于治疗抵抗的病例,应使用抗真菌药敏试验或分子方法来确定是否存在抗真菌耐药菌株。对于不能耐受局部和全身抗真菌治疗的患者,可以使用天然草药、激光和光动力治疗作为替代治疗。