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隐匿型癣:诊断与管理中的挑战

Tinea Incognito: Challenges in Diagnosis and Management.

作者信息

Zacharopoulou Aikaterini, Tsiogka Aikaterini, Tsimpidakis Antonios, Lamia Androniki, Koumaki Dimitra, Gregoriou Stamatios

机构信息

Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece.

Dermatology Department, University Hospital of Heraklion, 71110 Heraklion, Greece.

出版信息

J Clin Med. 2024 May 31;13(11):3267. doi: 10.3390/jcm13113267.

Abstract

Tinea incognito is a dermatophyte infection with atypical features, due to the use of topical or systemic steroids or other immunosuppressive medications. Delayed diagnosis, spread of the infection to critical body surfaces, resistance to antifungal drugs, and increased costs due to prolonged hospitalization and multiple treatment regimens often complicate tinea incognito. It can affect individuals of all ages and genders, but it is more common in children. Atypical clinical appearance often necessitates differentiation from other diseases such as eczema, seborrheic dermatitis, lupus erythematosus, psoriasis, or other non-fungal skin conditions. The treatment of tinea incognito usually involves discontinuation of topical steroids or other immunosuppressive medications. Preventive measures and management of the underlying fungal infection are necessary and can be achieved with antifungal drugs. Patients should wear loose cotton clothes, use boiling water for laundry, and iron their clothing before wearing them. Additionally, they should avoid sharing bed linens, towels, clothes, and shoes. This review aims to raise awareness of tinea incognito among health practitioners, provide tips for detecting the disorder, include it in the differentials, and evaluate the available diagnostic procedures.

摘要

隐匿型体癣是一种具有非典型特征的皮肤癣菌感染,是由于使用外用或全身性类固醇或其他免疫抑制药物所致。隐匿型体癣常因诊断延迟、感染扩散至关键身体部位、对抗真菌药物产生耐药性以及因长期住院和多种治疗方案导致费用增加而变得复杂。它可影响所有年龄和性别的个体,但在儿童中更为常见。非典型的临床表现常常需要与其他疾病如湿疹、脂溢性皮炎、红斑狼疮、银屑病或其他非真菌性皮肤病相鉴别。隐匿型体癣的治疗通常包括停用外用类固醇或其他免疫抑制药物。采取预防措施并治疗潜在的真菌感染是必要的,这可以通过抗真菌药物来实现。患者应穿宽松的棉质衣物,用开水洗衣服,并在穿着前熨烫衣物。此外,他们应避免共用床单、毛巾、衣服和鞋子。本综述旨在提高医护人员对隐匿型体癣的认识,提供检测该疾病的提示,将其纳入鉴别诊断,并评估现有的诊断程序。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3722/11172699/0a59e1b09dd4/jcm-13-03267-g001.jpg

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