抗真菌抗药性时代的皮肤和毛发皮癣菌专家小组综述。

IF 8.6 1区 医学 Q1 DERMATOLOGY American Journal of Clinical Dermatology Pub Date : 2024-03-18 DOI:10.1007/s40257-024-00848-1
Rachel C. Hill, Avrom S. Caplan, Boni Elewski, Jeremy A. W. Gold, Shawn R. Lockhart, Dallas J. Smith, Shari R. Lipner
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摘要

皮癣是皮肤、毛发和指甲的真菌感染,影响着全球约 25% 的人口。衣着暴露、生活在炎热潮湿的环境中、卫生条件差、接近动物和拥挤的生活环境是重要的风险因素。皮肤癣菌感染因其感染的解剖部位而得名,包括体癣、毛癣、头癣、倒刺癣、面癣、足癣和疥癣。隐性癣菌是指类固醇改变的癣菌。有些患者,尤其是免疫抑制患者或有皮质类固醇使用史的患者,皮癣菌感染可能会扩散到大面积皮肤,在极少数情况下,可能会扩展到真皮层和毛囊。在过去十年中,对标准疗法无效的皮癣病例报告越来越多。这些病例在印度次大陆尤为普遍,而且已确定吲哚毛癣菌是致病菌种,这引起了人们对现有抗真菌疗法耐药性的担忧。抗真菌耐药性皮癣菌感染最近在美国得到确认。抗真菌抗药性现已成为全球健康问题。在可行的情况下,最佳做法是在开始治疗前进行真菌学确认。为遏制抗真菌感染,医生有必要对耐药性皮真菌感染保持高度怀疑,并努力做好抗真菌管理工作。此外,通过与联邦机构、州和地方公共卫生机构、专业协会和学术机构建立合作关系,皮肤科医生可以领导防止抗真菌皮癣菌传播的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance

Dermatophytoses are fungal infections of the skin, hair, and nails that affect approximately 25% of the global population. Occlusive clothing, living in a hot humid environment, poor hygiene, proximity to animals, and crowded living conditions are important risk factors. Dermatophyte infections are named for the anatomic area they infect, and include tinea corporis, cruris, capitis, barbae, faciei, pedis, and manuum. Tinea incognito describes steroid-modified tinea. In some patients, especially those who are immunosuppressed or who have a history of corticosteroid use, dermatophyte infections may spread to involve extensive skin areas, and, in rare cases, may extend to the dermis and hair follicle. Over the past decade, dermatophytoses cases not responding to standard of care therapy have been increasingly reported. These cases are especially prevalent in the Indian subcontinent, and Trichophyton indotineae has been identified as the causative species, generating concern regarding resistance to available antifungal therapies. Antifungal-resistant dermatophyte infections have been recently recognized in the United States. Antifungal resistance is now a global health concern. When feasible, mycological confirmation before starting treatment is considered best practice. To curb antifungal-resistant infections, it is necessary for physicians to maintain a high index of suspicion for resistant dermatophyte infections coupled with antifungal stewardship efforts. Furthermore, by forging partnerships with federal agencies, state and local public health agencies, professional societies, and academic institutions, dermatologists can lead efforts to prevent the spread of antifungal-resistant dermatophytes.

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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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