LAMISIL IN CUTANEOUS OR LYMPHOCUTANEOUS SPOROTRICHOSIS

孢子菌病是一种由申克孢子丝菌引起的慢性皮下淋巴真菌感染，在世界范围内普遍存在。这种疾病是由刺或刺将真菌孢子引入皮肤或皮下组织引起的。孢子虫病可能是皮肤和皮下病变的有限疾病，也可能发展为播散性疾病，如果不治疗，是致命的。目前治疗孢子虫病的方法是口服饱和碘化钾溶液（SSKI）。该药物使用不便，作用机制尚不清楚，并可引起令人痛苦的副作用（活动样皮疹，金属味，腮腺和泪腺肿胀）。两性霉素B对播散性疾病有效，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。无论使用SSKI还是伊曲康唑，孢子菌病的治疗通常需要很长时间（3-6个月）。重要的是找到一种安全、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。当在有限数量的孢子菌病病例中使用时，它似乎对申克孢子菌具有良好的疗效，然而，需要以更大，更可控的方式对该药物进行进一步评估。在有限的病例中使用的剂量为250毫克，每天两次，长达12周。建议评估两种不同的剂量（每日500毫克和每日1000毫克）。

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).