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甲癬

甲癬
受甲癬感染的腳趾
类型真菌病nail infection[*]
病因红色毛癣菌鬚髮癬菌[*]斷髮癬菌[*]絮狀表皮癬菌犬小芽胞菌
分类和外部资源
醫學專科傳染病學、​皮肤病学
ICD-111F28.1
ICD-10B35.1
ICD-9-CM110.1
DiseasesDB13125
MedlinePlus001330
eMedicinederm/300
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甲癬(onychomycosis,tinea unguium)俗稱臭甲灰指甲,泛指受到真菌感染的指甲,通常影響腳趾,但手指甲也有可能出現。兩成指甲病是由甲癬所引起。

起因

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甲癬的成因是真菌感染,主要細為分酵母菌感染、霉菌感染,以及皮癬菌感染,包括引起足癬的真菌。

大約三分之一的糖尿病[1]、56%的牛皮癬患者會感染甲癬[2]

病徵

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甲癬的病徵有:趾甲變形、色變到灰褐色、暗黃色、趾甲變厚而難剪,但甲面變得很薄、很脆;有怪味,會痛。

它常易與單純的指甲畸形混淆[3],此外指甲银屑病、扁平苔癣、接触性皮炎、甲床腫瘤以及黄甲综合征產生的症狀都可能與灰指甲有相似之處,為避免誤診需要实验室檢查。[4]

治療

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服用特比萘芬十周後正在康復的患者指甲

治療灰指甲的方法很多,灰指甲大部分是由真菌引起的,治療灰指甲的藥物都是能夠消滅指甲真菌的,目前所採用的主要藥物和方式是手術拔除指甲、內服藥物、外用藥物和中醫治療灰指甲。

口服藥物主要包括特比萘芬伊曲康唑氟康唑。治愈後較易復發(10–50%)。[4]

参考文献

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  1. ^ Gupta AK, Konnikov N, MacDonald P, Rich P, Rodger NW, Edmonds MW, McManus R, Summerbell RC. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: A multicentre survey. The British Journal of Dermatology. 1998, 139 (4): 665–671. PMID 9892911. doi:10.1046/j.1365-2133.1998.02464.x. 
  2. ^ Gupta AK, Lynde CW, Jain HC, Sibbald RG, Elewski BE, Daniel CR, Watteel GN, Summerbell RC. A higher prevalence of onychomycosis in psoriatics compared with non-psoriatics: A multicentre study. The British Journal of Dermatology. 1997, 136 (5): 786–789. PMID 9205520. doi:10.1046/j.1365-2133.1997.6771624.x. 
  3. ^ American Academy of Dermatology, Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation (American Academy of Dermatology), February 2013 [5 December 2013], (原始内容存档于2015-04-10) . Which cites:*Roberts DT, Taylor WD, Boyle J. Villa Nail Salon. The British Journal of Dermatology. 2003, 148 (3): 402–410 [2019-03-15]. PMID 12653730. doi:10.1046/j.1365-2133.2003.05242.x. (原始内容存档 (PDF)于2017-08-10). 
  4. ^ 4.0 4.1 Westerberg DP, Voyack MJ. Onychomycosis: current trends in diagnosis and treatment.. American Family Physician. Dec 1, 2013, 88 (11): 762–70. PMID 24364524. 

參見

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外部連結

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甲癬
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