The treatment of ringworm

I. Systemic treatment

(A) ketoconazole (kefoconazole): nowadays, this drug is mostly taken internally as a substitute for ashwagandha. Ketoconazole is a synthetic broad-spectrum antifungal imidazole drugs. Its antifungal mechanism is to inhibit the synthesis of ergot succinol, an important component of fungal cell membrane, leading to the loss of the normal function of the cell membrane of the fungus, resulting in the increase of membrane permeability, and finally causing the fungus to degenerate and even die. According to clinical practice, this drug has good efficacy in superficial fungal diseases.

Indications: mainly used for ringworm of the head, followed by generalized tinea corporis, severe tinea cruris and ringworm of the nails.

Contraindications: Abnormal liver function, pregnancy and lactation women are prohibited this drug.

Dosage: adults, 200mg, 1 time / day. Children weighing less than 20 kilograms, 50mg, 1

times/day; 20 to 40 kilograms, 100mg, 1 time/day; over 40 kilograms can be taken according to the adult dose.

(ii) other imidazoles: Itraconazole (Itraconazole) antifungal efficacy for ketoconazole 5 to 10 times, used in the treatment of dermatophytosis of the minimum dose of 100mg daily can be.

Two, local treatment

Not involved in the hair or deck of the superficial fungal disease, the use of local therapy can be effective, but the need for patience, adhere to a longer period of time to wipe the medicine. Commonly used two groups of drugs.

(I) external unique drugs: can choose special drugs Ketorolac drops, external coating of the affected area,

(II) specific broad-spectrum antifungal agents: currently widely used in the largest family of imidazole ring have **** the same imidazole ring, i.e., imidazole drugs such as thioconazole (fioconazole), miconazole (Miconazole), oximeconazole (oxiconazole), econazole (oxiconazole), and the other two groups of drugs are used in the treatment of fungal diseases. ), econazole (econazole) ketoconazole (ketoconazole) Bifonazole (Bifonazole) and Clotrimazole (chlorotrimazole Iotrimazoie), etc. are often made into 1 to 2% cream for clinical application.

Three, a variety of superficial fungal disease specific treatment method

(A) ringworm

China has summarized a set of "five words therapy" good experience, that is, serving (medicine), washing (head), applying (medicine), treatment (hair), eliminating (poison). Against this experience, we can use ketoconazole internal, according to the above dose, for 4 weeks; during the treatment period must be washed daily; adhere to the external application of appropriate antifungal ointment for 1 ~ 2 months; weekly haircut, until the cure; the patient's daily necessities, such as hats, towels, pillows, combs, etc., must be disinfected on a regular basis.

(2) tinea corporis, tinea cruris, tinea pedis

It should be firmly believed that this kind of ringworm local treatment can be effective, but according to the different conditions, different lesions manifestation, and the use of different dosage ringworm medicine.

1, ringworm medicine complication infection, should first control the infection.

2, the lesion is swollen and oozing obviously, can choose 3% boric acid water or 0.02% furacillin solution wet compress, once the swelling, oozing reduced and then choose the effective treatment of ringworm topical medicine.

3, the affected area is erosion and a small amount of oozing, must first be Huanglian zinc oxide oil topical transition for 2 to 3 days, and then replace the appropriate ringworm ointment.

4, lesions manifested as scaly keratinized type, the treatment of ringworm ointment type of ointment or cream for proper.

5, such as damage to the phenomenon of cracking, avoid using tincture external application, still choose ointment or cream is good.

6, the rash to erythema, papules, can choose tincture or ointment and cream.

7, the face, the inner part of the stock and other parts of the skin lesions, prohibit the use of high-concentration exfoliators, so as not to stimulate and cause dermatitis.

8, as long as the dosage form selection is not wrong, more advocate should not frequently change the topical medicine. Each kind of ringworm treatment ointment should be used for at least one week.

9, the condition of stubborn or extensive skin lesions, the application of local therapy to cure the difficulty, can consider giving ketoconazole internal, 200mg, 1 time / day, for 4 weeks.

(C) ringworm

This disease in principle should also be the main local treatment, but due to the deck is quite thick, the general drug is not easy to penetrate into, so can not take the usual treatment of ringworm to deal with this disease. Before using local medicine, you should try to remove the nail plate, and then use antifungal medicine externally. Commonly used methods are introduced as follows:

(a) scraping nail method: daily with a knife as much as possible to scrape off the brittle part of the sick nail, and then apply 5% tincture of iodine, 30% glacial acetic acid, or Wei's liquid, adhere to the 1 ~ 2 times a day, until healed.

(2) dissolve nail method: first to protect the skin around the nail with adhesive tape, and then 25-40% urea ointment coated on the nail plate, and then finally covered with plastic film, and fixed with adhesive tape. Every 2 days to change the medicine, to be softened by the nail plate has a sense of floating, with tweezers to pull out the nail plate, followed by daily change in accordance with the routine, such as wound healing and then external ringworm ointment, until the growth of a good nail.

If the above methods of treatment fails or the number of sick nails, can also consider casting with ketoconazole orally, the dose is the same as above, often need about six months to cure.

(4) lichen planus

This disease is easy to cure, but also often recur. Traditional medicine, such as 20-40% sodium thiosulfate solution, 2.5% selenium sulfide emulsion can be effective, in addition, imidazole cream can also get satisfactory results.

(E) ringworm rash

The systemic treatment of this disease can be dealt with according to the principles of treatment of allergic dermatosis; local antifungal drugs are not required, especially avoid using the stimulation of the stronger ringworm drugs. You can use mild zinc oxide oil or 3% boric acid water wet compress can be used. In addition, must actively treat active ringworm foci.