Mercurio M G, Elewski B E
Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106.
Semin Dermatol. 1993 Dec;12(4):285-9.
Sporotrichosis is a fungal infection caused by the dimorphic organism, Sporothrix schenkii. This etiologic agent typically gains entrance into the skin by traumatic implantation of infected soil or plant materials. The majority of cases are of the fixed cutaneous or lymphangitic cutaneous varieties, and less commonly, hematogenous dissemination to skin or viscera occurs. Untreated, the disease may spontaneously resolve or persist and gradually progress over time, its virulence being less than that of other dimorphic fungi. Potassium iodide remains a favored treatment for uncomplicated cutaneous disease. Amphotericin B, with its high toxicity, has historically been reserved for recalcitrant cutaneous or disseminated disease. Itraconazole, the newest triazole antifungal to become available in the United States, seems to be highly effective against Sporothrix schenkii without significant adverse effects and will likely become the first line therapy for all forms of this disease in the future.
孢子丝菌病是一种由双相真菌申克孢子丝菌引起的真菌感染。这种病原体通常通过受感染的土壤或植物材料的创伤性植入进入皮肤。大多数病例为固定皮肤型或淋巴管皮肤型,较少见的是血行播散至皮肤或内脏。未经治疗,该病可能会自行缓解或持续存在,并随时间逐渐进展,其毒力低于其他双相真菌。碘化钾仍然是治疗单纯皮肤疾病的首选药物。两性霉素B毒性高,历来仅用于治疗顽固性皮肤或播散性疾病。伊曲康唑是美国最新上市的三唑类抗真菌药,似乎对申克孢子丝菌高度有效且无明显不良反应,未来可能会成为该病所有类型的一线治疗药物。