TAILIEUCHUNG - Clinical Dermatology - part 7

Hệ thống này là cần thiết cho bệnh nấm da của da đầu, móng tay, và các bệnh nhiễm trùng lan rộng hoặc mãn tính của da mà không đáp ứng với các biện pháp địa phương. | 218 CHAPTER 14 Systemic This is needed for tinea of the scalp or of the nails and for widespread or chronic infections of the skin that have not responded to local measures. Terbinafine Formulary 2 p. 342 has now largely superceded griseofulvin. It acts by inhibiting fungal squalene epoxidase and does not interact with the cytochrome P-450 system. It is fungicidal and so cures chronic dermatophyte infections more quickly and more reliably than griseofulvin. For tinea capitis in children for example a 4-week course of terbinafine is as effective as an 8-week course of griseofulvin. Cure rates of 70-90 can be expected for infected fingernails after a 6-week course of terbinafine and for infected toenails after a 3-month course. It is not effective in pityriasis versicolor or Candida infections. Griseofulvin Formulary 2 p. 343 was for many years the drug of choice for chronic dermatophyte infections. It has proved to be a safe drug but treatment may have to be stopped because of persistent headache nausea vomiting or skin eruptions. The drug should not be given in pregnancy or to patients with liver failure or porphyria. It interacts with coumarin anticoagulants the dosage of which may have to be increased. Its effectiveness falls if barbiturates are being taken at the same time. Griseofulvin is fungistatic and treatment for infected nails has to be prolonged an average of 12 months for fingernails and at least 18 months for toenails . The disappointing results for toenail infections seen in some 30-40 of cases can be improved by the concomitant use of topical nail preparations see above . LEARNING POINTS 1 Do not prescribe griseofulvin terbinafine or itraconazole for psoriasis of the nails or chronic paronychia. Get mycological proof first. 2 Your patient s asymmetrical eczema is spreading despite local steroids think of a dermatophyte infection. 3 Consider tinea in acute inflammatory and purulent reactions of the scalp and beard. Itraconazole Formulary 2 p. 343 is .

TỪ KHÓA LIÊN QUAN
Đã phát hiện trình chặn quảng cáo AdBlock
Trang web này phụ thuộc vào doanh thu từ số lần hiển thị quảng cáo để tồn tại. Vui lòng tắt trình chặn quảng cáo của bạn hoặc tạm dừng tính năng chặn quảng cáo cho trang web này.