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Onychomycosis is a nail infection caused by dermatophytes, non-dermatophyte fungi, and yeasts, especially Candida species. The present study evaluated the combinatorial effect of different cultured extracts of Candida parapsilosis and Trichophyton mentagrophytes and Trichophyton rubrum with fluconazole, itraconazole, and terbinafine against clinical isolates of Trichophyton rubrum. In addition, investigation of the action of the extracts on the wall or membrane was performed. Pure and mixed cultures of Candida parapsilosis and dermatophytes were filtered through a 0.2-µm membrane and submitted to liquid-liquid extraction using ethyl acetate. After a checkerboard, trial with drugs was performed to evaluate the synergistic interaction with the extract. The results obtained for the minimum inhibitory concentration (MIC) of extracts against the T. rubrum strain in isolation were 500-8000 µg/mL. The MIC range for fluconazole, itraconazole, and terbinafine were 2-32 µg/mL, 0.25-0.5 µg/mL, 0.03-64 µg/mL, respectively. However, when the extract was combined with drugs, the MIC values decreased: extracts 1.9-1000 µg/mL, fluconazole 0.25-4, itraconazole 0.03-0.06 µg/mL, and terbinafine 0.001-0.02 µg/mL. The MIC values of the extracts in the Roswell Park Memorial Institute 1640 medium (RPMI) supplemented with sorbitol did not change, suggesting any action on the cell wall. However, in the presence of RPMI supplemented with ergosterol, MIC values of the extracts increased by up to 2×, indicating action on the fungal cell membrane. A synergistic action was observed between products and drugs, detecting a decrease in MIC values. There is potential and a new therapeutic perspective for fungal control.

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Abstract Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

Resumo As plantas medicinais são prescritas há muito tempo na Tailândia, há séculos. Diferentes constituintes de extratos têm sido usados para o tratamento de várias doenças infecciosas. No entanto, existem ainda menos informações disponíveis sobre o uso em infecções fúngicas da pele. A fim de avaliar as alegações tradicionais tailandesas sobre o potencial terapêutico, este estudo está focado em explorar a propriedade antidermatófita das plantas que são usadas atualmente como medicamentos tradicionais. O potencial de quatro espécies de plantas diferentes foi selecionado para investigar a atividade antidermatófita in vitro. Extratos etanólicos de Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.) e Acorus calamus (L.) foram analisados quanto ao seu conteúdo fenólico total, bem como ao conteúdo de flavonoides totais. E então submetidos ao teste de suas propriedades antidermatófitas usando o método de difusão em ágar bem. A análise qualitativa de flavonoides e fenólicos dos extratos mostrou seus constituintes biologicamente ativos. Entre as espécies examinadas, o resultado indicou que a maioria dos extratos demonstrou atividade antidermatófita. Em particular, A. calamus mostrou a maior eficácia contra organismos de teste. O experimento confirmou os constituintes químicos e a eficácia de algumas plantas selecionadas e fornece uma confirmação científica do uso de plantas tailandesas na medicina tradicional para infecções fúngicas da pele.

RESUMO

Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

As plantas medicinais são prescritas há muito tempo na Tailândia, há séculos. Diferentes constituintes de extratos têm sido usados para o tratamento de várias doenças infecciosas. No entanto, existem ainda menos informações disponíveis sobre o uso em infecções fúngicas da pele. A fim de avaliar as alegações tradicionais tailandesas sobre o potencial terapêutico, este estudo está focado em explorar a propriedade antidermatófita das plantas que são usadas atualmente como medicamentos tradicionais. O potencial de quatro espécies de plantas diferentes foi selecionado para investigar a atividade antidermatófita in vitro. Extratos etanólicos de Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.) e Acorus calamus (L.) foram analisados quanto ao seu conteúdo fenólico total, bem como ao conteúdo de flavonoides totais. E então submetidos ao teste de suas propriedades antidermatófitas usando o método de difusão em ágar bem. A análise qualitativa de flavonoides e fenólicos dos extratos mostrou seus constituintes biologicamente ativos. Entre as espécies examinadas, o resultado indicou que a maioria dos extratos demonstrou atividade antidermatófita. Em particular, A. calamus mostrou a maior eficácia contra organismos de teste. O experimento confirmou os constituintes químicos e a eficácia de algumas plantas selecionadas e fornece uma confirmação científica do uso de plantas tailandesas na medicina tradicional para infecções fúngicas da pele.

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INTRODUCTION: A dermatophytoma is a mass of hyphae that is observed at direct examination, it responds poorly to treatment with antifungal drugs, some authors have proposed that it is actually a biofilm. This pathology is underdiagnosed, and its true incidence is unknown. OBJECTIVES: This study presents the clinical findings of dermatophytoma in HIV/AIDS patients from Colombia presenting onychomycosis. MATERIAL AND METHODS: A transversal observational descriptive study was carried out in a third level university hospital. One hundred thirty HIV positive patients diagnosed using ELISA and Western Blot that presented nail lesions on their hands and/or feet compatible with onychomycosis were included. Samples taken from affected nails were observed in direct examination with KOH and seeded onto Sabouraud agar, mycosel agar and dextrose-potato agar. Molds were identified based on macroscopic and microscopic characteristics. RESULTS: Six (4.6%) individuals presented dermatophytoma. Average age was 43 years (range 33-50); nails more commonly affected (5/6) were on the toes, principally the hallux. Clinical manifestations included a yellow or white, rounded or linear dense area on the nail. Superficial white onychomycosis was present in 83.3% of the patients. Fungal cultures were obtained in only 5 patients; Trichophyton mentagrophytes complex was found in 2 individuals while T. rubrum, T. tonsurans and Epidermophyton floccosum were in the other 3. Average cell count for CD4+T lymphocytes was 86.8 cells/mm3 (range 9-282). CONCLUSIONS: This is the first report in Colombia of dermatophytoma in HIV/AIDS patients, most of them had a CD4+ T lymphocytes count less than 200 cells/mm3. Several clinical forms of onychomycosis were observed, the most frequent was the white superficial onychomycosis.

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We evaluated a hydroalcoholic extract of Sapindus saponaria L. pericarps (ETHOSS), as a candidate to a topical antifungal medicine for onychomycosis. ETHOSS was produced by extracting the crushed fruits in ethanol. The saponin contents were identified and characterized by electrospray ionization mass spectrometry. We measured the in vitro antifungal activity against three dermatophyte fungi, isolated from onychomycosis: Trichophyton rubrum, T. mentagrophytes, and T. interdigitale, using broth microdilution tests. The minimum fungicide concentration of ETHOSS ranged from 195.31 to 781.25 µg/mL. The cytotoxicity of the crude extract was tested on the HeLa cell line, and its ability to permeate into healthy human nails by photoacoustic spectroscopy and Fourier transformation infrared spectrometer (FTIR) spectroscopy by attenuated total reflection. Besides its strong antifungal activity, ETHOSS showed low cytotoxicity in human cells. It was able to permeate and reach the full thickness of the nail in one hour, without the aid of facilitating vehicles, and remained there for at least 24 h. These results suggest that ETHOSS has great potential for treating onychomycosis.

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AIM: To evaluate the antifungal activity of extracts of Chamaecostus cuspidatus against Candida and Trichophyton species. METHODS AND RESULTS: Crude ethanol extracts of leaves, stems and rhizomes were prepared and evaluated for antimicrobial activity. Only the rhizomes extract (RE) showed antifungal activity but had no inhibitory effect against bacteria (Staphylococcus aureus and Escherichia coli). The RE was then submitted to liquid-liquid partition with hexane (Hex), dichloromethane, chloroform, ethyl acetate and water. The Hex fraction (Hex Fr) from the RE was found to have the best antifungal effect. Three known saponins were isolated from the Hex Fr, of which two (dioscin and aferoside A) showed good antifungal activity. In addition, Hex Fr and the two bioactive compounds had no antibacterial effect, but exhibited fungicidal activity, caused significant changes in the morphology of the fungal cells and showed anti-Candida albicans biofilm activity. Finally, the bioactive plant products presented greater selectivity for fungal cells over normal human cells. CONCLUSIONS: The rhizomes of C. cuspidatus have bioactive saponins that function as effective antifungals against Candida and Trichophyton species, and have antibiofilm activity against C. albicans. SIGNIFICANCE AND IMPACT OF THE STUDY: Chamaecostus cuspidatus REs may have potential clinical application towards the management of superficial mycoses caused by Candida and Trichophyton species.

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Dermatophytosis, commonly known as ringworm, is a zoonotic disease caused by complex fungi that grow as hyphae and attach to the skin, hair and nails or claws. About 40 species of fungi of the genera Microsporum spp., Trichophyton spp. and Epidermophyton spp. are considered dermatophytes, and Microsporum canis is the genus most commonly isolated from cats. This study investigated the occurrence of dermatophytes in cats without clinical signs of skin diseases. The study involved the physical examination of 50 clinically healthy cats and the collection of samples for direct examination and fungal culture at a university veterinary hospital. The resulting data were evaluated by the chi-square association test. Of the 50 cats, 11 (22%) presented dermatophytes, with a predominance of Microsporum spp. The other 39 animals were diagnosed for non-dermatophytic fungi. Sex, breed and the presence of contactants showed no statistical difference, although there was a predominance of adult animals. The high dermatophyte infection rate confirms that cats without clinical signs can harbor these fungi, acting as asymptomatic carriers, contaminating the environment and increasing the infection rate. This study confirms that cats without clinical signs can be carriers of ringworm, which underscores the importance of the adoption of control methods even for clinically healthy animals.

Dermatofitose é uma zoonose causada por fungos complexos que crescem como hifas e se fixam na pele superficial, pelo e unhas. Existem cerca de 40 espécies de fungos pertencentes aos gêneros Microsporum, Trichophyton e Epidermophyton, considerados dermatófitos e, destes, o mais isolado em gatos é o Microsporum canis. Este estudo teve o objetivo de verificar a ocorrência de dermatófitos em felinos, ausentes de sinais clínicos de dermatopatias. Em Hospital Veterinário Universitário, 50 gatos clinicamente saudáveis foram avaliados e submetidos ao exame físico, coleta de amostra para exame direto e cultura fúngica. Os dados foram avaliados por Teste de Associação Qui-quadrado. Dos 50 gatos, 11 (22%) apresentaram dermatófitos, com predomínio de Microsporum spp. Os outros 39 animais foram diagnosticados para fungos não dermatófitos. Não foi observada diferença estatística para sexo, raça ou presença de contactantes, mas houve predomínio de animais adultos. A elevada taxa de infecção por dermatófitos confirma que felinos sem sinais clínicos podem albergar estes fungos, agindo como carreadores assintomáticos e, consequentemente, contaminando o ambiente e elevando a taxa de infecção. Este trabalho confirma que gatos sem sinais clínicos podem ser portadores de dermatofitose, fato que evidencia a importância de adoção de método de controle, mesmo em animais clinicamente saudáveis.

RESUMO

Dermatophytosis, commonly known as ringworm, is a zoonotic disease caused by complex fungi that grow as hyphae and attach to the skin, hair and nails or claws. About 40 species of fungi of the genera Microsporum spp., Trichophyton spp. and Epidermophyton spp. are considered dermatophytes, and Microsporum canis is the genus most commonly isolated from cats. This study investigated the occurrence of dermatophytes in cats without clinical signs of skin diseases. The study involved the physical examination of 50 clinically healthy cats and the collection of samples for direct examination and fungal culture at a university veterinary hospital. The resulting data were evaluated by the chi-square association test. Of the 50 cats, 11 (22%) presented dermatophytes, with a predominance of Microsporum spp. The other 39 animals were diagnosed for non-dermatophytic fungi. Sex, breed and the presence of contactants showed no statistical difference, although there was a predominance of adult animals. The high dermatophyte infection rate confirms that cats without clinical signs can harbor these fungi, acting as asymptomatic carriers, contaminating the environment and increasing the infection rate. This study confirms that cats without clinical signs can be carriers of ringworm, which underscores the importance of the adoption of control methods even for clinically healthy animals.

Dermatofitose é uma zoonose causada por fungos complexos que crescem como hifas e se fixam na pele superficial, pelo e unhas. Existem cerca de 40 espécies de fungos pertencentes aos gêneros Microsporum, Trichophyton e Epidermophyton, considerados dermatófitos e, destes, o mais isolado em gatos é o Microsporum canis. Este estudo teve o objetivo de verificar a ocorrência de dermatófitos em felinos, ausentes de sinais clínicos de dermatopatias. Em Hospital Veterinário Universitário, 50 gatos clinicamente saudáveis foram avaliados e submetidos ao exame físico, coleta de amostra para exame direto e cultura fúngica. Os dados foram avaliados por Teste de Associação Qui-quadrado. Dos 50 gatos, 11 (22%) apresentaram dermatófitos, com predomínio de Microsporum spp. Os outros 39 animais foram diagnosticados para fungos não dermatófitos. Não foi observada diferença estatística para sexo, raça ou presença de contactantes, mas houve predomínio de animais adultos. A elevada taxa de infecção por dermatófitos confirma que felinos sem sinais clínicos podem albergar estes fungos, agindo como carreadores assintomáticos e, consequentemente, contaminando o ambiente e elevando a taxa de infecção. Este trabalho confirma que gatos sem sinais clínicos podem ser portadores de dermatofitose, fato que evidencia a importância de adoção de método de controle, mesmo em animais clinicamente saudáveis.

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Debido al pleomorfismo y variabilidad macroscópica que presenta el género Trichophyton, 1os métodos de identificación basados exclusivamente en caracteres morfológicos no son suficientes para su clasificación. El objetivo fue evaluar las características morfológicas y bioquímicas de aislados clínicos identificados como Trichophyton spp. Se estudiaron 98 cultivos, identificados previamente por macro y micromorfología y se reevaluaron por: microcultivo en lámina, perforación del pelo in vitro, hidrólisis de urea y uso de agares Trichophyton y BCP-MS-G. El análisis morfológico y las pruebas de hidrólisis de urea y perforación del pelo arrojaron 51% T. rubrum, 24% T. mentagrophytes, 16,6% T. interdigitale, 7% T. tonsurans y 2% Trichophyton spp. La prueba de urea evidenció un error de 9,4%. La evaluación mediante el BCP-MS-G permitió diferenciar T. rubrum tipo A algodonoso de T. interdigitale, e identificar Trichophyton spp. como T. rubrum tipo B granular. La concordancia entre la evaluación previa y la reevaluación fue de un 70% y entre las pruebas morfofisiológicas y BCP-MS-G fue de 96%. Se detectó un 30% de sobrediagnóstico de T. rubrum. Se sugiere el empleo del medio BCP-MS-G para diferenciar T. interdigitale de T. rubrum tipo A y otros biotipos de T. rubrum tipo B.

Due to the pleomorphism and macroscopic variability of the Trichophyton genus, identification methods based solely on the morphological characteristics are insufficient for its classification. The objective was to evaluate the morphological and biochemical characteristics of clinical isolates of Trichophyton spp. The study included 98 isolates previously identified by macro and micromorphology that were reassessed by means of microculture sheet, in vitro hair perforation, urea hydrolysis and culture on Trichophyton and BCP-MS-G agars. For morphological analysis, urea hydrolysis tests and in vitro hair perforation results were: T. rubrum 51%, T. mentagrophytes 24%, T. interdigitale 16.6%, T. tonsurans 7% and Trichophyton spp. 2%. The urea hydrolysis test showed 9.4% error. Culture on the BCP-MS-G medium allowed to differentiate T. rubrum cottony A type from T. interdigitale and the identification of Trichophyton spp. as T. rubrum granular B type. The agreement between the previous assessment and reassessment was 70% and when morphophysiological and BCP-MS-G culture were considered, agreement reached 96%. There was 30% overdiagnosis for T. rubrum. Cultures on BCP-MS-G agar are suggested to differentiate T. interdigitale from T. rubrum A type and other biotypes of T. rubrum B type.

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Num total de 1.238 casos de dermatofitoses, ocorridas na Cidade de Recife /PE, observou-se predomínio das tinhas de couro cabeludo (33,7 por cento) e Trichophyton tonsurans (25,5 por cento), entre 1995 e 1999, enquanto as tinhas de pele glabra (35,5 por cento) e Trichophyton rubrum (34 por cento) foram mais freqüentes entre 2000 e 2005. Detectou-se importante redução do Trichophyton mentagrophytes, no último período.

Out of a total of 1,238 cases of dermatophytosis in the city of Recife (Pernambuco), lesions of the scalp (33.7 percent) and Trichophyton tonsurans (25.5 percent) predominated between 1995 and 2000, while lesions of the hairless skin (35.5 percent) and Trichophyton rubrum (34 percent) were the most frequent between 2000 and 2005. A significant reduction in Trichophyton mentagrophytes was detected in the second of these periods.

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