Trichophyton rubrum, Scytalidium dimidiatum, Epidermophyton floccosum. All of the above are the names of the mushrooms that cause the common dermatological disease. We are talking about superficial mycoses that affect hair, nails and smooth skin. In many countries, dermatomycosis occupies a leading position, so the question “Mycosis: treatment” worries mycologists around the world.
In general, mycoses of the feet and hands are treated with systemic drugs, as well as external means. In addition to eliminating the symptoms of fungal infection, treatment of associated diseases is carried out.
Consider the features of treatment depending on the lesion:
Patients who are concerned about the question "How to treat foot mycosis?" Need to know that the main method of treating fungal diseases of the feet is the use of local antifungal drugs.
When squamous form: 1-2 p / day. topically Ketoconazole , Clotrimazole , Naftifine , Terbinafin , Econazole in the form of a cream, ointment or solution; treatment with 2% iodine solution in the evening (if necessary).
In the acute form: calcium gluconate intramuscularly or intravenously, calcium pantothenate 0.5 g. Orally; chloropyramine orally 2-3 times a day for 0.025 g; a solution of potassium permanganate or boric acid topically 2 times a day for 1-2 days; resorcinol in the form of a solution 1-2 times a day for 1-2 days; Miconazole ointment 7-10 days, 2 times a day.
If external therapy is not effective, then systemic drugs are prescribed. All of them are taken after meals for 3-4 weeks (except for itraconazole ): terbinafine - 250 mg. daily, fluconazole - 150 mg. once a week, itraconazole - 200 mg. for 7 days, then the dose is reduced to 100 mg. daily.
In the presence of bacterial flora, ointments (creams), betamethasone, neomycin, gentamicin (applied twice a day for 3-5 days in a row) or baths with potassium permanganate 2-3 times a day for 1-2 days are additionally prescribed.
If hyperkeratosis is diagnosed, then the horny layer is removed.
Treatment of nail mycosis may require the appointment of systemic therapy, but in most cases it is enough to take local medications. Sometimes dermatologists resort to combination therapy. The decision is made with an eye on the type of pathogen, the area of the lesion and the neglect of the disease.
For mycosis on the hands are the same rules as for the legs and other skin areas. So, it is possible to do with local preparations only in the case of the distal-lateral form of nail mycosis, when the fungus has captured no more than 1/3 of the nail plate. In all other cases, local preparations are meaningless to use: their active components will not be able to penetrate into the deep layers of the dermis and destroy the causative agent of the disease.
Consider how the treatment of nail mycosis occurs with drugs prescribed by physicians.
Preparations of systemic action:
- Terbinafine (trade names - exifin , lamisil , terbizil ) - affects T. rubrum and T. Mentagrophytes. The regimen: with the defeat of the hands in 250 mg. 6 weeks, with mycosis of the feet - 12 weeks at 250 mg.
- Itraconazole (analogue - orungal ) - detrimental effects on fungi of any kind. Regimen: 1 week at a dose of 200 mg. twice a day with a three-week interval. The course is repeated twice with onychomycosis of the feet and once with the defeat of the nail plate brushes.
- Fluconazole ( Diflucan ) - affects yeast fungi and dermatophytes. Dosage regimen: 2-6 weeks, 150 mg. once a week or once a day for 50 mg.
These products come in the form of creams or solutions and are applied to the affected nails once or twice a day, until the healthy nails grow back.
Treatment of mycosis of toenails can be carried out with a special dosage form - antifungal varnishes. They, unlike many drugs do not adversely affect the kidneys and liver of the patient. In addition, they can be combined with ordinary cosmetic varnishes. The greatest effect is achieved with the use of medicinal varnishes ciclopirox (batrafen) and amorolfin (loceril) .
The treatment of this disease is carried out with antifungal drugs taken externally and orally. In rare cases, pathogenetic therapy is carried out.
The main remedy in this case is antifungal shampoo . Additionally, the doctor may prescribe pills.
Consider the main drugs used to treat mycosis of the head.
- Griseofulvin is considered to be a fairly effective drug, but it has side effects. The treatment regimen for microsporia: children - 21-22 mg. on 1 kg. weights, adults - 12.5 mg. on 1 kg. weight (maximum amount - 1 gr.). Treatment regimen for trichophytia: children - 18 mg. per 1 kg weight, adults - 12.5 mg. on 1 kg. weights; 3 p. on the day until the fungus disappears completely (laboratory test shows), then the drug is taken every other day for 14 days and 14 days twice a week. Official instructions for use here . Systemic treatment with griseofulvin is reinforced externally: rubbing Nizoral , Mifungar, Mikospor , Bifosin , Mikozoral , Batrafen 1-2 times a day into the affected areas of the cream.
- Terbinafine - with a mass of more than 40 kg. 250 mg. once a day, with a mass of from 20 to 40 kg. - 125 mg., Up to 20 kg - 65 mg. The drug is taken after a meal. The duration of treatment is 4-12 weeks.
- Itraconazole - suitable only for adults. It is taken 4-6 weeks at 100 mg. in a day.
The above local antifungal agents are used only after relieving inflammation. Thus, the infiltrative-suppurative form of mycosis of the scalp requires prior removal of the crusts and manual epilation of the hair.
This goal is achieved by applying lotions with antiseptic solutions, applying dressings with salicylic ointment, using anti-inflammatory drugs such as furatsilin, rivanol. In the chronic form with the help of a special ointment, first remove the horny layer of the epidermis.
Treatment of children, even newborns, is not difficult. They are prescribed griseofulvin in the infant dose, and if the child is breastfed, the mother takes the drug.
The most dangerous type of mycosis of the skin, the treatment of which is the difficulty - fungal mycosis. At the initial stage, the disease is similar to eczema, psoriasis and other dermatoses, because the first symptoms are red-bluish itching spots that appear on any part of the body.
Then the spots infiltrate and turn into plaques. The disease develops slowly, and plaques may appear after 5-10 years from the onset of the disease. This is one of the reasons why people go to doctors already at the tumor stage, when plaques begin to fester and bleed, and the tissues become necrotic.
No need to wait for dystrophic changes and damage to internal organs. It is worth beating a bell in cases where the femoral and inguinal lymph nodes have unreasonably increased, and night sweats have appeared.
Treatment of fungal mycosis is successful only in the early stages. Inside they prescribe steroid hormones and arsenic preparations, in advanced cases - cytotoxic drugs and antitumor antibiotics. Sometimes they carry out X-ray therapy, phototherapy, and extracorporeal photochemotherapy.