Yakima Valley Farm Workers Clinic, Washington.
Department of Family and Community Medicine, University of Texas Health, San Antonio.
FP Essent. 2024 Jun;541:20-26.
Tinea infections are caused by dermatophytes, except for tinea versicolor, which is caused by yeasts in the genus. If available, potassium hydroxide preparation should be performed to confirm diagnosis of tinea capitis or onychomycosis. In some cases, fungal culture, UV light examination, or periodic acid-Schiff stain can be helpful. Topical drugs are effective for tinea corporis, tinea cruris, and tinea pedis. Tinea incognito is an atypical presentation that usually requires systemic treatment. Management of tinea capitis always requires oral drugs. Oral drugs are preferred for onychomycosis treatment but should not be prescribed without confirmation of fungal infection. Localized cases of tinea versicolor can be managed with topical drugs, but oral drugs might be needed for severe, widespread, or recurrent cases. Warts are superficial human papillomavirus infections. Common treatments include irritant, destructive (eg, cryotherapy), immune stimulant (eg, intralesional antigen), and debridement and excision methods. Scabies infestation results in intensely itchy papules, nodules, or vesicles. Mites and burrows on the skin are pathognomonic but difficult to identify. Dermoscopy, particularly with UV light, can make identification easier. Topical permethrin and oral ivermectin are two of the most commonly used treatments. All household and close contacts should be treated regardless of the presence or absence of symptoms.
癣菌感染由真菌引起，除花斑癣外，花斑癣由 属酵母引起。如果可行，应进行氢氧化钾制剂检查以确认头癣或甲真菌病的诊断。在某些情况下，真菌培养、紫外线检查或过碘酸雪夫染色可能会有所帮助。局部药物对头癣、股癣和足癣有效。癣菌隐匿是一种非典型表现，通常需要全身治疗。头癣的治疗始终需要口服药物。口服药物是治疗甲真菌病的首选方法，但在未确认真菌感染的情况下不应开处方。局部花斑癣可使用局部药物治疗，但对于严重、广泛或复发性病例，可能需要口服药物。疣是由人乳头瘤病毒引起的浅表感染。常见的治疗方法包括刺激剂、破坏剂（如冷冻疗法）、免疫刺激剂（如皮内抗原）以及清创和切除术。疥疮感染会导致剧烈瘙痒的丘疹、结节或水疱。皮肤上的螨虫和隧道是特征性的，但难以识别。皮肤镜检查，特别是在紫外线照射下，可使识别更容易。最常用的治疗方法包括外用 5% 二氯苯醚菊酯和口服伊维菌素。无论有无症状，所有家庭和密切接触者都应接受治疗。
