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目的：寻找更好的方法诊断和治疗角化脱屑型手足癣。方法：对１７４例临床拟诊为角化脱屑型手足癣的患者采用改良ＫＯＮＣＰＡ法进行真菌学检查，并与ＫＯＨ法、真菌培养法进行对照。受试患者随机予以伊曲康唑０．２ｇ，２／ｄ，用７ｄ（Ⅰ组）；０．２ｇ，２／ｄ，用１４ｄ（Ⅱ组）；特比萘芬０．２５ｇ，１／ｄ，用１４ｄ（Ⅲ组）；质量分数为０．０１的萘替芬霜外用３０ｄ（Ⅳ组）及０．０１（质量分数）特比萘芬霜外用３０ｄ（Ⅴ组）进行治疗。结果：ＫＯＨ法检查真菌阳性率为６２．４％，真菌培养法为８６．７８％，改良ＫＯＮＣＰＡ法为１００％（Ｐ＜０．００１）。Ⅰ组治愈８例（８／３０），有效１３例（１３／３０）；Ⅱ组治愈３１例（３１／５１），有效４２例（４２／５１）；Ⅲ组治愈２２例（２２／３３），有效３２例（３２／３３）；Ⅳ组治愈２２例（２２／３６），有效３５例（３５／３６）；Ⅴ组治愈１７例（１７／２４），有效２４例（２４／２４）。结论：（１）改良ＫＯＮＣＰＡ法明显优于ＫＯＨ法与真菌培养法；（２）萘替芬霜或特比萘芬霜可作为首选药；（３）伊曲康唑０．２ｇ，２／ｄ，１４ｄ疗法明显优于７ｄ疗法；（４）特比萘芬治疗角化脱屑型手足癣临床疗效优于伊曲康唑
Objectives: To find better ways to diagnose and treat keratosis and scaling type of hand, foot and ringworm. Methods: A total of 174 cases of clinically diagnosed as keratosis - type hand - foot ringworm patients with improved KONCPA method for mycological examination, and KOH method and fungal culture were compared. Patients were randomized to itraconazole 0.2g, 2 / d, with 7d (group Ⅰ); 0.2g, 2 / d, with 14d (group Ⅱ); terbinafine 0.25g, 1 / d (N = 15), nifedipine cream (n = 30) for 30 days (n = 5) and terbinafine cream 0.01 (mass fraction) for 30 days (Ⅴ group). Results: The positive rate of KOH test for fungi was 62.4%, fungal culture method was 86.78%, and modified KONCPA method was 100% (P <0.001). In group Ⅰ, 8 cases (8/30) were cured and 13 cases (13/30) were effective. In group Ⅱ, 31 cases were cured (31/51) and 42 cases were effective (42/51) , 32 cases (32/33) were effective in group Ⅳ, 22 cases (22/36) were cured in group Ⅳ, 35 cases (35/36) were effective in group Ⅳ, 17 cases (17/24) were cured in groupⅤ, and 24 cases were effective in 24 cases. Conclusion: (1) KONCPA method is better than KOH method and fungal culture method; (2) Naftifine cream or terbinafine cream can be used as the preferred drug; (3) Itraconazole 0.2g, 2 / d , 14d therapy was significantly better than the 7d therapy; (4) Terbinafine in the treatment of keratosis scaling hand-foot ringworm superior clinical efficacy than itraconazole