Onychomycosis 2010 Clinics In Dermatology英文电子书.pdf

Clinics in Dermatology (2010) 28, 151–159 Onychomycosis a,⁎ a b Oliverio Welsh, MD , Lucio Vera-Cabrera, DrSc , Esperanza Welsh, MD aDepartment of Dermatology, Dr. Jose Eleuterio Gonzalez University Hospital, Avenida Francisco I. Madero y Avenida Gonzalitos s/n, Colonia Mitras Centro, Monterrey, Nuevo Leon 64460, Mexico b Centro de Especialidades Médicas, Jose Benitez 2704, Colonia Obispado Monterrey, Nuevo Leon 64460, Mexico Abstract Onychomycosis is a frequent nail disease caused by dermatophytes, yeasts, and nondermatophyte molds. Trichophyton rubrum, T mentagrophytes, and Epidermophyton floccosum are the most common etiologic agents worldwide. Candida spp are the most frequent among the yeasts. Diagnosis is corroborated by direct microscopic examination, culture, and histomycology with periodic acid-Schiff stain. Other new methods of diagnosis are discussed. Treatment is based on oral antifungals: terbinafine, itraconazole, and fluconazole, including other emerging triazole drugs. Therapeutic outcome with ciclopirox and amorolfine lacquers alone and combined with systemic therapy are also reviewed, as well as the new nail enhancers and physical and chemical removal of the diseased nails. © 2010 Elsevier Inc. All rights reserved. Introduction Most onychomycoses are caused by dermatophytes that belong to three genera: Trichophyton, Microsporum, and Onychomycosis is the most common affection of the nails Epidermophyton . Several fungi can be causative agents, (more than 50%). The term indicates infection by dermato- but three speci