LAMISIL IN CUTANEOUS OR LYMPHOCUTANEOUS SPOROTRICHOSIS

孢子丝菌病是一种由申克孢子丝菌引起的慢性皮下淋巴肌感染，在世界范围内普遍发生。 这种疾病是由于真菌孢子通过刺或碎片进入皮肤或皮下组织而引起的。 孢子虫病可以是皮肤和皮下病变的局限性疾病，或者它可以进展为播散性疾病，如果不治疗，是致命的。 孢子虫病目前用口服饱和碘化钾溶液（SSKI）治疗。 这种药物服用不方便，其作用机制尚不清楚，可能导致几种令人痛苦的副作用（放射状皮疹，金属味，腮腺和泪腺肿胀）。 两性霉素B是治疗播散性疾病的有效药物，但对局部皮肤病无效。 伊曲康唑尚未被批准用于孢子虫病，但已被有效利用。 孢子虫病的治疗通常是漫长的（3-6个月），无论是否使用SSKI或伊曲康唑。重要的是要找到一种安全的，可能更有效的替代伊曲康唑治疗孢子虫病。 特比萘芬在欧洲被安全地用于治疗各种真菌感染。 在有限数量的孢子虫病病例中使用时，似乎对申克孢子丝菌具有良好的疗效，然而，需要以更大、更受控的方式对该药物进行进一步评价。 有限病例中使用的剂量为250 mg每日两次，持续12周。 建议评价两种不同剂量（500 mg qd和1000 mg qd）。

Sporotrichosis is a chronic, subcutaneous, lymphatic mycotic infection due to Sporothrix schenckii which occurs with worldwide prevalence. This disease follows introduction of the fungal spores into the skin or subcutaneous tissues by a thorn or splinter. Sporotrichosis can be a limited disease of the skin and subcutaneous lesions, or it may progress to a disseminated disease which, untreated, is fatal. Sporotrichosis is currently treated with orally administered saturated solution of potassium iodine (SSKI). This drug is inconvenient to take, its mechanism of action is unclear and it can cause several distressing side effects (actineform rash, metallic taste, parotid and lacrimal gland swelling). Amphotericin B is an effective treatment for disseminated disease but it is not effective for local cutaneous disease. Itrconazole has not been approved for use in sporotrichosis, however, it has been effectively utilized. Treatment for sporortrichosis is usually lengthy (3-6 months), regardless of whether SSKI or itraconazole is utilized. It is important that a safe, possibly more effective alternative to itraconazole be found to treat sporotrichosis. Terbinafine is safely used in Europe in the treatment of various fungal infections. It apears to have good efficacy against Sporothrix schenckii when utilized in a limited number of sporotrichosis cases, however, further evaluation of this drug is needed in a larger, more controlled fashion. The dose used in the limited cases was 250 mg twice daily for up to 12 weeks. It is proposed that two different doses be evaluated (500 mg qd and 1000 mg qd).