Mock M, Monod M, Baudraz-Rosselet F, Panizzon R G
Mycology Laboratory, Département Hospitalier Universitaire Romand de Dermatologie et Vénéréologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Dermatology. 1998;197(4):361-7. doi: 10.1159/000018032.
Tinea capitis is a worldwide-spread infection of the scalp caused by dermatophytes and is predominantly seen in children. The clinical manifestations range from mild scaling lesions to widespread alopecia or highly inflammatory suppurating lesions. Terbinafine and itraconazole seem to be promising therapies with shorter treatment durations than griseofulvin.
The objective of the present study was to test the sensitivity of different species of dermatophytes towards terbinafine and itraconazole, and to compare the results with a retrospective study on 35 immunocompetent patients with tinea capitis who were treated with terbinafine (Lamisil(R)).
Minimal inhibitory concentrations (MIC) were measured with an agar dilution method.
Each tested species of dermatophyte was sensitive to terbinafine and itraconazole at different concentration ranges. The MIC for terbinafine ranged from 0.005 to 0.5 microg/ml and for itraconazole from 40 to 80 microg/ml. Microsporum canis was the dermatophyte least sensitive to terbinafine. Our retrospective study showed that the cure rate was excellent for Trichophyton violaceum and T. soudanense, variable for T. mentagrophytes and poor for M. canis and M. langeronii.
(i) Regarding the results of susceptibility tests obtained with species involved in tinea capitis, clinical efficacy is not related to MIC measured in vitro; (ii) identification of the isolated dermatophyte from tinea capitis seems to be important for choosing the appropriate treatment.
头癣是一种由皮肤癣菌引起的在全球范围内传播的头皮感染，主要见于儿童。其临床表现从轻度鳞屑性损害到广泛脱发或高度炎症性化脓性损害不等。特比萘芬和伊曲康唑似乎是比灰黄霉素治疗疗程更短的有前景的治疗方法。
本研究的目的是测试不同种类皮肤癣菌对特比萘芬和伊曲康唑的敏感性，并将结果与一项对35例接受特比萘芬（兰美抒®）治疗的免疫功能正常的头癣患者的回顾性研究进行比较。
采用琼脂稀释法测量最低抑菌浓度（MIC）。
每种受试皮肤癣菌在不同浓度范围内对特比萘芬和伊曲康唑敏感。特比萘芬的MIC范围为0.005至0.5微克/毫升，伊曲康唑的MIC范围为40至80微克/毫升。犬小孢子菌是对特比萘芬最不敏感的皮肤癣菌。我们的回顾性研究表明，紫色毛癣菌和苏丹毛癣菌的治愈率极佳，须癣毛癣菌的治愈率不一，犬小孢子菌和兰氏小孢子菌的治愈率较差。
（i）关于头癣相关菌种的药敏试验结果，临床疗效与体外测量的MIC无关；（ii）对头癣分离出的皮肤癣菌进行鉴定似乎对选择合适的治疗方法很重要。
