查看Ch75 Dermatological Pharmacology的源代码

== Onychomycosis (甲癣) ==

甲癣是一种指甲真菌感染，通常由皮肤癣菌或念珠菌引起。甲癣用全身疗法治疗最有效（de Sa et al.， 2014）。在开始口服治疗之前，应确认是否为真菌感染。指甲生长异常还有其他原因，大约三分之一的临床疑似甲癣的指甲没有真菌感染（Mehregan 和 Gee，1999 年）。

Onychomycosis is a fungal infection of the nails that is commonly caused by dermatophytes or Candida. Onychomycosis is most effectively treated with systemic therapy (de Sa et al., 2014). Fungal infection should be confirmed prior to initiating oral therapy. There are other causes of nail dystrophy, and approximately one-third of nails with clinically suspected onychomycosis do not have fungal infection (Mehregan and Gee, 1999).


<b style=color:#f80>特比萘芬 (Terbinafine)</b>是治疗皮肤癣菌性甲癣菌病的<b style=color:#0b0>最有效方法</b>，典型的成人剂量为每天 250mg，指甲持续 6 周，脚趾甲持续 12 周。特比萘芬在停药后可在指甲中保留数周，基于这一发现，一些研究利用特比萘芬 500mg/d 脉冲给药，每月 1 周，持续 3 个月。

Terbinafine is the most effective treatment of dermatophyte onychomycosis, with typical adult dosing of 250 mg daily for 6 weeks for fingernails and 12 weeks for toenails. Terbinafine remains in the nails for several weeks after medication administration has ceased, and some studies have utilized pulsed dosing of terbinafine 500 mg daily for 1 week per month for 3 months based on this finding.


<b style=color:#f80>伊曲康唑 (Itraconazole) </b>是治疗皮肤癣菌性甲癣菌病的另一种有效选择，并且比特比萘芬对念珠菌性甲癣更有效。伊曲康唑在停药后可在指甲中持续存在 6 至 9 个月。伊曲康唑的传统成人剂量为每天 200mg，指甲持续 6 周，脚趾甲持续 12 周；然而，脉冲给药是一种替代选择，因为伊曲康唑在给药停止后仍持续留在指甲中。伊曲康唑在成人中的冲击剂量为每天 400mg，每月 1 周，指甲持续 2 个月，脚趾甲持续 3 个月，这可能会最大限度地减少不良反应。<b style=color:#f80>氟康唑 (Fluconazole) </b>是一种替代选择，可能对不能使用特比萘芬或伊曲康唑的患者有用。

Itraconazole is another effective option for dermatophyte onychomycosisand is more effective than terbinafine for candidal onychomycosis. Itraconazole persists in the nail for 6 to 9 months after administration has ceased. Traditional adult dosing for itraconazole is 200 mg daily for 6 weeks for fingernails and 12 weeks for toenails; however, pulsed dosing is an alternative option because of itraconazole’s persistence in the nail after administration has ceased. Itraconazole pulsed dosing in adults is 400 mg daily for 1 week per month for 2 months for fingernails and 3 months for toenails, which may minimize adverse effects. Fluconazole is an alternative option that may be useful in patients who cannot use terbinafine or itraconazole.

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