| Literature DB >> 35957972 |
Anusha Sharma1, Sarika Gupta1.
Abstract
Background and Aims: Fungal dermatophytosis or Tinea is a predominance in about 20%-25% of all total world populations. Dermatophyte infections are mainly caused by fungi belonging to Trichophyton, Epidermophyton, and Microsporum genera along with some other fungi. This epidemiological distribution may change with migration, lifestyle, immunosuppressive state, drug therapy, and socioeconomic conditions.Entities:
Keywords: antifungal activity; fungal dermatophytic; herbalnanoceuticals and green synthesis; medicinal plants
Year: 2022 PMID: 35957972 PMCID: PMC9364328 DOI: 10.1002/hsr2.775
Source DB: PubMed Journal: Health Sci Rep ISSN: 2398-8835
Figure 1The schematic way in which dermatophytes enter the host system
Salient features of dermatophytosis
| Clinical type | Synonym | Site of infection | Causative agents | Symptoms | References |
|---|---|---|---|---|---|
|
| Barber's itch | Beard, mustache hair |
| Like |
[
|
|
| Roundworm | Scalp hair |
| Noninflammatory lesions characterized by patches of alopecia with scaling and broken hairs. Inflammatory lesions show tender boggy swelling |
[
|
|
| Ringworm | Nonhairy skin of the body |
| Erythematous scaly annular plaques |
[
|
|
| Jock itch, dhobi itch | Nonhairy skin of the groin |
| Erythematous scaly annular plaques |
[
|
|
| Kerion | Nonhairy skin of the face |
| Erythematous scaly annular plaques |
[
|
|
| Hands | Palms |
| Diffuse scaling of palm |
[
|
|
| Athlete's foot | Feet |
| Fissuring, scaling, or maceration in the interdigital or sub digital areas |
[
|
|
| Onychomycosis | Fingers, toenails |
| Subungual scaling and lifting of the distal nail |
[
|
Note: Epidermophyton sp.: E. floccosum; Microsporum sp.: M. canis; Trichophyton sp.: T. mentagrophytes, T. rubrum, T. interdigitale, T. violaceum. , , , , , , ,
Recommended dosing of different systemic antifungal in dermatophytosis
| Class | Drug | Preparation | Disease state | Dosage | Target of organism | Medicinal property | References |
|---|---|---|---|---|---|---|---|
| Azoles (Imidazoles) | Clotrimazole | Cream, gel, lotion, solution, powder |
| 4–5 (troches) once daily for 10–14 days |
| Anti‐inflammatory, anticancer, antifungal, antiviral, wound healing |
[
|
| Ketoconazole | Cream, lotion, shampoo, soap, powder |
|
2% Cream apply once daily 2 weeks Oral 200–400 mg/once daily for 4 weeks |
| Antiviral, antifungal |
[
| |
| Miconazole | Cream, lotion | Oral candidiasis, canine | 50‐mg once in daily for 10‐14 days |
| Antibacterial, antiprotozoal |
[
| |
| Azoles (Trinazoles) | Fluconazole | Cream, Gel, Lotion, Powder, Solution |
| Oral: 150–300 mg once weekly 2–4 weeks |
| Antiviral, antifungal |
[
|
| Itraconazole | Cream |
| 200 mg/day in two times daily 1–2 weeks |
| Antiviral, antifungal |
[
| |
| Efinaconazole | Solution |
| One troche dissolved in the mouth five times a day for 2 weeks |
| Antiviral, antifungal |
[
| |
| Allylamines | Naftifine | Cream, gel, solution, powder |
|
|
| Antifungal |
[
|
| Terbinafine | Cream, gel |
| 250 mg once daily for 1 week every 1 month |
| Antifungal, anti‐inflammatory |
[
| |
| Benzylamines | Butenafine | Cream |
| 1% (Mentax) cream 1 week or once daily for 4 weeks |
| Antifungal, antiviral |
[
|
| Polyenes | Amphotericin B | Lipid based gel |
| 1 mg/kg once daily for 2–4 weeks. |
| Antifungal |
[
|
| Nystatin | Cream | Oral thrush, intestinal infection, vaginal infection, cutaneous infection | 4–5 per daily for 10–14 days |
| Antifungal |
[
|
Note: Aspergillus spp.: A. flavus, A. fumigates, A. terreus; Blastomyces sp.: B. dermatitidies, Candida sp.: C. albicans; Cryptococcus sp.: C. neoformans; Epidermophyton sp.: E. floccosum; Histoplasma sp.: H. capsulatum; Malassezia sp.: M. furfur; Microsporum spp.: M. audouini, M. canis, M. gypseum; Trichophyton spp.: T. interdigitale, T. mentagrophytes, T. rubrum, T. tonsurans, T. violaceum). , , , ,
Figure 2Conventional treatment role of topical antifungals and systemic antifungals
Classification and mechanism of action of antifungal antibiotics , , ,
| Class | Drug | Mechanism of action | Mode of action | Side effects | References |
|---|---|---|---|---|---|
| Azoles (Imidazoles) | Clotrimazole | Inhibition of fungal lanosterol 14 demethylase causes ergosterol depletion then sterol build‐up in the fungal cell membrane, which is dangerous |
Fungistatic, fungicidal | Local irritation, allergic reactions |
[
|
| Ketoconazole | Hepatotoxicity |
[
| |||
| Miconazole | Liver damage, nausea, arrhythmias, pruritus, hyponatraemia, hyperlipidaemia, dyscrasias |
[
| |||
| Azoles (Triazoles) | Fluconazole | Ergosterol production is inhibited, resulting in a decrease in the integrity and activity of fungal cell membranes |
Fungistatic, fungicidal | Hepatic toxicity, increased plasma concentrations of (topical/oral) anaphylaxis, stevens‐Johnson syndrome, hypokalaemia, exfoliative skin disorders, agranulocytosis, thrombocytopenia, toxic epidermal necrolysis, adrenal cortex dysfunction |
[
|
| Itraconazole | Liver function (but hepatotoxicity is milder than ketoconazole, and hypokalaemia with hypertension is caused by corticosteroids with aldosterone‐like action accumulating. Nausea, epigastric discomfort, headache, and edema are all symptoms of leukopenia. Causing heart failure in patients who are elderly or on calcium channel blockers |
[
| |||
| Efinaconazole | |||||
| Oral burning, xerostomia, altered taste, minor GI‐upset followed by oral ingestion of the drug, allergic reactions | |||||
| Allylamines | Naftifine | Squalene epoxidase inhibition: activity linked to squalene accumulation's harmful consequences | Fungistatic | Burning, erythema, dryness, itching |
[
|
| Terbinafine | It inhibits squalene epoxidation, a key initial stage in the formation of ergosterol, by functioning as a noncompetitive inhibitor of fungal squalene epoxidase |
Fungistatic, fungicidal | Hepatobiliary dysfunction, induction, agranulocytosis, exacerbation of lupus, severe skin reactions |
[
| |
| Benzylamines | Butenafine | Interferes with ergosterol production by blocking the enzyme squalene 2, 3 epoxidase, which converts squalene to squalene oxide | Fungicide |
[
| |
| Polyenes | Amphotericin B | It's an antifungal that's classified as “polyene.” Polyenes bond to ergosterol found in fungi (the primary sterol in fungal cell membranes). The permeability of the cell membrane is altered, and intracellular components seep out of the cell. Depending on the level of concentration in the body |
Fungistatic, fungicidal | Serum creatinine, complete blood counts, serum magnesium, blood urea nitrogen, serum sodium, serum potassium, liver function test result must be monitored. When it is used with amino glycosides or neuromuscular blockers, prolonged skeletal muscle paralysis |
[
|
| Nystatin | It's a polyene‐based antifungal that exclusively effects on | Fungicidal | GI‐ upset is common when nystatin is taken orally |
[
|
Patent herbal formulation and their use against skin infection
| Patent no. | Title | Used part | Remarks | Used for | References |
|---|---|---|---|---|---|
| US 7,714, 183 B2 | Honey is used in dressings | Honey buffer | Buffer in conjunction with a variety of medicinal and surgical dressings of the required consistency and viscosity | Honey will be used as a wound healing |
[
|
| US 2013/0146481 A1 | Bioactive compounds derived from | Possible plant bioactive components | The innovation is based on isolated bioactive chemicals | To prevent inflammatory behavior, protect skin tissue from UV radiation damage, and normalize skin disorders in mammals |
[
|
| US 2013/0323337 A1 | A regenerative medication based on a novel herbal combination for wound healing | Extracts obtained from | The present invention is based on a novel, synergistic, and effective herbal composition as a regenerative medicine, which includes a combination of therapeutically effective amounts | To treat would healing |
[
|
| WO 2014/147638 Al | A natural wound healing matrix with several functions | Tulsi and Curcumin fragments are extracts with herbal medicinal values to increase their properties and have herbal medicinal values | A multifunctional natural wound‐healing matrix is the subject of this invention. A wound bed consisting of a hydrophilic cotton fabric is the basis for the current concept. One side is covered with zwitterionic chitosan with a low molecular weight, which is implanted on top of the silver nanoparticles created | To treat would healing |
[
|
| US 8,709, 509 B2 | A regenerative medication composed of herbs for the treatment of wound healing | Extracts obtained from | This invention discloses a novel, synergistic, and effective herbal composition as a regenerative medicine that includes a combination of therapeutically effective amounts | To treat skin disease |
[
|
| EP 2 896 396 A1 | Topical wound therapy using an herbal formulation | This breakthrough refers to modern herbal blends that may be used topically antimicrobial agents | To facilitate wound healing, in the form of an emulsifying agent and a product that contains at least one herbal component with analgesic, antifungal, anti‐inflammatory, and antibacterial properties | To cure skin and mucosal lesions |
[
|
| WO 2019/078931 Al | Wound‐healing dressing with buckwheat honey and bacitracin | A synthesis or preparation containing a combination of buckwheat honey and bacitracin | The component is gelled in a single encarnation | A method for treating acute and chronic wounds and skin disorders, as well as regenerating skin or dermal tissue in a chronic wound, is the most recent invention |
[
|
| US 2019/0201474 A1 | Formulation of herbal oils for topical use and medicinal uses | Herbal oil based on | Dry gangrene, diabetic gangrene, foot ulcer, wet gangrene, burn wounds, bed sores, snake bite wounds, chronic open wounds, diabetic, and gangrene caused by cellulitis are among the therapeutic conditions for which the disclosed topical herbal oil formulation provides an inexpensive alternative healing therapy | The current disclosure is for a topically applied for treating and curing a range of skin disorders and illnesses, as well as all forms of wounds and other therapeutic circumstances linked with diminished human and animal blood flow |
[
|