中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (12): 1130-1133.doi: 10.35541/cjd.20250428

• 专家论坛·真菌感染性皮肤病 • 上一篇    下一篇

皮肤真菌感染诊疗的现状、挑战与思考

余进    李若瑜   

  1. 北京大学第一医院皮肤科,北京  100034
  • 收稿日期:2025-08-06 修回日期:2025-09-11 发布日期:2025-12-04
  • 通讯作者: 李若瑜 E-mail:mycolab@126.com
  • 基金资助:
    国家重点研发计划(2022YFC2504801)

Diagnosis and treatment of cutaneous fungal infections: current status, challenges, and perspectives

Yu Jin, Li Ruoyu   

  1. Department of Dermatology, Peking University First Hospital, Beijing 100034, China
  • Received:2025-08-06 Revised:2025-09-11 Published:2025-12-04
  • Contact: Ruoyu Li E-mail:mycolab@126.com
  • Supported by:
    National Key Research and Development Program of China(2022YFC2504801)

摘要: 【摘要】 皮肤真菌感染是临床常见疾病,病原谱复杂,且随着免疫状态改变、抗真菌药物应用及环境因素变化,其流行趋势和病原分布呈现显著变化。本文系统回顾国内外皮肤真菌感染的诊疗现状、核心挑战及未来优化方向。目前诊断技术包括传统真菌镜检、培养及分子诊断,分子方法显著提高诊断敏感性和时效性,但无法完全替代传统手段;人工智能辅助真菌图像识别技术展现出应用潜力。治疗以外用和口服抗真菌药物为主,但耐药菌株的涌现及免疫缺陷患者难治性感染成为临床挑战。新型药物及纳米载体技术为治疗提供新的选择。我国已建立全国皮肤真菌病监测网,但基层诊疗能力不足、患者依从性差等问题仍突出。未来需通过普及分子诊断、动态耐药监测、个体化治疗及基层能力建设,构建多学科协作体系,并加强国际合作以应对全球耐药传播。

关键词: 皮肤真菌病, 皮肤真菌感染, 耐药性, 分子诊断, 人工智能, 个体化治疗, 监测网络

Abstract: 【Abstract】 Cutaneous fungal infections are clinically common diseases with a complex pathogenic spectrum. Significant changes in their epidemiological trends and pathogen distribution have been observed due to alterations in immune status, antifungal drug use, and environmental factors. This article systematically reviews the current status of, core challenges in, and future optimization strategies for the diagnosis and treatment of cutaneous fungal infections in China and other countries. Current diagnostic techniques include traditional fungal microscopy, fungal cultures, and molecular methods. Although molecular methods have significantly improved the sensitivity and timeliness of diagnosis, they cannot completely replace conventional approaches. Artificial intelligence-assisted fungal image recognition technology shows promising potential for application. Their treatment primarily relies on topical and oral antifungal agents, but the emergence of drug-resistant strains and refractory infections in immunocompromised patients pose clinical challenges. Novel drugs and nanocarrier technologies offer new therapeutic options. A national surveillance network for dermatophytoses has been established in China, but challenges persist, such as inadequate diagnostic and therapeutic capabilities at the primary care level and poor patient compliance. Future efforts should focus on promoting molecular diagnostics, implementing dynamic antifungal resistance surveillance, advancing personalized treatment, strengthening primary care capabilities, establishing a multidisciplinary collaborative system, and enhancing international cooperation to control the global transmission of antifungal resistance.

Key words: Dermatomycoses, Cutaneous fungal infection, Drug resistance, Molecular diagnosis, Artificial intelligence, Personalized treatment, Surveillance network

引用本文

余进 李若瑜. 皮肤真菌感染诊疗的现状、挑战与思考 [J]. 中华皮肤科杂志, 2025,58(12):1130-1133. doi:10.35541/cjd.20250428

Yu Jin, Li Ruoyu. Diagnosis and treatment of cutaneous fungal infections: current status, challenges, and perspectives[J]. Chinese Journal of Dermatology, 2025, 58(12): 1130-1133.doi:10.35541/cjd.20250428