Rich P
Oregon Health Sciences University, Portland, USA.
J Am Acad Dermatol. 1996 Sep;35(3 Pt 2):S10-2. doi: 10.1016/s0190-9622(96)90063-8.
There are approximately 14 million persons with diabetes in the United States. These patients must cope with the serious complications of this disease, including neuropathy and impaired circulation (leading to the "diabetic foot" and possible amputation), renal disease, cardiovascular disease, and retinopathy (possibly leading to blindness). Although onychomycosis is no more common in diabetics than in the general population, it poses a greater risk because of the possible sequelae. Most notably, impaired sensation can make many diabetics less aware of minor abrasions and ulcerations on their feet that may be caused by trauma from poor nail grooming or by the nail changes characteristic of onychomycosis. These lesions, in turn, may develop into serious bacterial infections and contribute to the severity of the diabetic foot. Thus there is an important clinical rationale for treating diabetic patients with fungal nail infections. A secondary benefit is the improved self-esteem and enhanced quality of life.
美国约有1400万人患有糖尿病。这些患者必须应对这种疾病的严重并发症，包括神经病变和循环系统受损（导致“糖尿病足”并可能需要截肢）、肾脏疾病、心血管疾病和视网膜病变（可能导致失明）。虽然甲癣在糖尿病患者中的发病率并不高于普通人群，但由于可能产生的后遗症，它带来的风险更大。最值得注意的是，感觉功能受损会使许多糖尿病患者对脚部因指甲修剪不当或甲癣特有的指甲变化而受到的轻微擦伤和溃疡不太在意。这些损伤反过来可能发展成严重的细菌感染，并加重糖尿病足的严重程度。因此，治疗糖尿病患者的指甲真菌感染具有重要的临床依据。另一个好处是能增强自尊，提高生活质量。
