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IS IT POSSIBLE TO INFLUENCE DERMATOMYCOSIS ECOLOGICALLY?
Karel Mencl
Laboratory of medical mycology, Microbiological section of
Hospital Pardubice
Microscopic fungi causing skin disease and their andex
are a continuous problem for health care and they constantly fill the
consulting rooms of dermatologists, even though, in the last few years, the
study of their importance and epidemiology stood in the shadows of opportinistic
mycotic infections, which cause organ and system diseases to risk patients. Even
though these diseases are indisputably more serious, since they endanger
patients life, we should not forget about skin. After all, it is an important
human organ too. Dermatomycosis
mainly affects lower limbs, especially in interdigital areas (tinea
interdigitalis) and toenails (onychomycosis, tinea unguium). From the
epidemiological point of view, most of toenail afflictions have their origins in
neglected or overlooked mycotic infections in interdigital areas. Many me return from their military service with this
disease (10, 11), others can get infected by wearing other’s shoes, on mats in
shared bathrooms or showers, in swimming pools etc. Paradoxically this may be
caused by ”obsession wit healthy lifestyle”, which brings more and more
people to swimming pools, saunas and other sporting facilities. But even hot
sauna may not be a guarantee of mycologically clean and healthy surrounding
(9). Common
cause for the start of personal disease is the wearing of airtight, or
insufficiently aired shoes, sweating of feet and insufficient care of feet
burdened this way. Wet asphyxiation,
skin maceration and mechanical micro-traumatism together with over breeding of
microbiological flora, especially GR-bacteria (13), then prepares, besides
unpleasant odor, suitable environment for microscopic fungi. If sufficient
attention is not given to this state, affliction of nail disk. Bio-preparation
”Biodeur” During
my visit of a pharmacy, I was attracted by a bio-preparation, in
the annotation of which it’s written that it successfully fights odor and
fungi. Taking into consideration the fact that since my military service I suffer,
in periods when my feet sweat, from occasional recidivation of interdigital
mycosis, which I then have to forcefully liquidate using various
chemotherapeutics and because I was suffering from such recidivation at
that time and since I’ve been professionally engaged with medical mycosis for
over 20 years, I decided to try out this bio-preparation. ”Tests on my
own body” passed without complications and with excellent results. Since
there was no reference about the constitution of the preparation, as it is in
many other cosmetics, I decided to contact the manufacturer and ask for
more information. Thanks to the willingness of the company and the author of the
recipe, I found out that it is an original composition of microorganisms,
which is dominated by micromycet, which is, as a mycoparasite, able to
affect on other mycotic organisms, e.g. Trichophyton rubrun, Scoupulariopsis
brevicaulis, Candida albicans etc. by penetrating its parasitic hyphas into
their fibre and cells and drains nitrogen and carbon from them for it’s own
alimentation and concurrently drains sterols for its own reproductive process.
This way the micromycet -vampire, exhausts the fungus and causes pathological
process through its propagation in keratin structures of infected skin.
Parasitic fungus stops propagating in the skin and unpleasant itch disappears.
The weakening of parasitic fungus allows for own immune mechanisms to be put in
practice and the skin removes the remains of mycotic infections by natural
pealing of keratin. Meanwhile the other components of the preparation help to
dry the interdigital areas of feet, by sweat suppression. The whole effect is
caused on the basis of alimentation and space competition, which the preparation
pushes out from the interdigital ares by pathogenic microflora. Information onpactical use of bio-preparation
Considering the fact that the cosmetic bio-preparation
Biodeur has been available on our market for quite some time and owing to my
professional orientation in laboratory diagnostics of human mycosis, I decided,
for the purpose of problem study and also as a basis for this article, to
obtain records of survey observing the effects of the preparation from the
manufacturer. The survey was realized by a number of Czech dermatologists
in their consulting rooms and with the help of patients, which agreed with the
use of Biodeur preparation for this purpose and had positive laboratory results
for the occurrence of mycosis. This observed patient (n=69) applied the
preparation onto the infected areas according to instructions. It was either a
30 minute feet bath two days in a row, repeater once more after 7 days and
again after another 7 days or if nails were affected the procedure was combined
by poultice technique over night an at the same intervals. The
age composition of the observed group was various (table 1). The youngest
patient was 19, the oldest 77 years old. Their difficulties were represented by
symptoms and diagnosis of hyperidrosis (n=43), odor symptoms (n=42), Tinea pedis
or Tinea interdigitalis. All 69 observed patients were examined for the presence
of microscopic fungi in infected areas and only a positive result was a reason
to be included in the program, in which the effects of the bio-preparation were
observed. From the given table (Table 2) it is visible that mycosis could
diagnosed only by microscope in more than 50% of patients. Such a high number
does not correspond to some literary data (4), and also doesn’t correspond to
personal laboratory experience. In cases of positive cultivation, finding of
dermatophytes prevailed (n=21), which represents the interception of these fungi
in 30.4% of observed persons. Out of this number, the finding of Trichophytom
rubrum (n=12) corresponded to 40% of all positive cultivations. On
the basis of subjective evaluations by persons included in the survey and on the
basis of objective evaluation by the attending doctors, the following results
arose (table 3). During the basic use of the preparation, odor symptoms were
removed in 78.6% of cases and odor symptoms were significantly improved in 19%
of cases. In the case of hyperidrosis it was so in 67.4% and 27.9% of observed
persons. The evaluation of success of the use of the bio-preparation in the case
of elimination of microscopic fungi from the mycosis symptoms was done only on
the basis of clinical data of attending doctor, since complete sets of
laboratory control examinations were not available. According to the clinic it
appears that in tinea pedis and tinea interdigitalis symptoms, it is possible to
improve the overall state of all people affected with a full cease of
symptoms in 82.8% of persons. In the case of onychomycosis, it is very difficult
to evaluate in such a short time, but it appears that a certain improvement
can be observed in 72.9% of treated persons. In this case a positive
success was considered to be the decrease in hyperkeratotic matter under the
nail disk, partial growth of new – healthy nail, change in color of the
infected nail disk and last but not least relief of pain symptoms of
onychomycosis. Discussion
The use of bio-preparations is not wide spread in
medicine and only professionals from the sphere of plant protection (
) dealt with this problem more. If the antagonistic relations and
”killer” phenomenon of some microscopic fungi could be used to fight
micromycets that endanger life, or decreasing the life comfort of a person,
it would be a significant move forward. These bio-preparations could find
their significance mainly in treatment of dermatomycosis, especially in older
patients, or people affected by other basic diseases, when it is not possible to
use system anti-mycotics. Further then in persons where a potential risk of
allergy is present or persons with eczema from topic chemotherapy. Here
is no doubt that such people can be found in large numbers. According to a large
study (1), which took place in 20 European states and covered over 100 00
patients, the factors increasing the risk of mycotic disease are: a) males (non-mycotic
disease prevail in females), b) age (maximum in ages 75-80 years), c) vascular
disease, d) sport leading to the traumatisation of lower limb, e) diabetes (DM)
and f) overweight. The Czech republic took two second places considering
predisposition factors: in the number of causes due to vascular disease and DM.
Mycotic infections in the individual countries were confirmed clinically. The
Czech Republic was surprised by the large percentage of affected population –
more than 40% had clinically diagnosed onychomycosis, more than 60% had tinea
pedis. Clinically diagnosed mycotic disease was confirmed mycologically (cultivation
investigation). This way it was proven that incidence (25-80/1000 inhabitants)
and prevalence (413/1000 inhabitants) of feet affection is higher than it was
expected to be and that the most common mycosis is the onychomycosis and tinea
pedis. The affection of fingernails is also not rare. It originates as secondary
factor, when in foot affection the same pedicure and manicure instruments are
used on fingernails. As
it arises from working inter-branch meetings of dermatologists, clinic and
laboratory mycologists, the onychomycosis is in every case an infectious disease
affecting 2.5% of population. It is a frequent manifestation of mycotic
infections and is a cause for at least 50% of all nail diseases. Even
though it isn’t a disease that endangers life, it must not be considered
as only a cosmetic problem. It is a potential chronic ailment, which
requires at least the same amount of attention as other skin diseases. This
affection usually bothers the patient for a long time, it distinguishes by
a large number of recidivations, may be quite painful and can lead to
psychological trauma and significant decrease in the quality of life. It worsens
manual skills or mobility, makes it impossible to work in certain professions (nurses,
employees of food service, typists or operators, in the case of feet e.g. ballet
dancers), it prevents the undertaking of some recreational activities (keyboard
or guitar playing, certain kinds of sports – soccer), it reduces social
contacts, brings lower self esteem, fear of spreading of the disease onto other
fingers or onto other family members, including children or grandchildren. The
main sources of the foot and hand affection are the dermatophyts (90% in
toenails affection and at least 50% in fingernails) (6). This finding confirms
our observation. It also corresponds to our finding that we find fungus in these
ailments. Lately the occurrence of non-dermatophytic affections of nails by
fibric microscopic fungi is on the increase and that not only in the case of
Scopulariopsis brevicaulis. Even though the interception of these ......... was
described many times in the past (3, 5, 7, 8, 10, 14), they were usually rare
isolations. In the present we very well meet these instigators on a regular
basis, which can be connected to the prolongation of middle life span (onychomycosis
is more frequent with age) and the increasing number of people with lowered
immunity (patients using immunosupressives, steroids or chemotherapeutics ) and
other diseases (diabetes etc.),because the fungi Aspergillus, Fusarium,
Alternaria etc. belong among microorganisms causing secondary mycosis in altered
persons. The interceptions of such fungi amounted to 13.4% of all positive
cultivation interceptions in the group observed by us and this number is not
neglectable. Conclusion
Mycotic skin diseases and skin andex, especially
onychomycosis, pose a serious problem taking into consideration medical,
epidemiological, psychosocial and somatic consequences and their importance
rises in connection with the increase of occurrence on the worldwide and
national scale. This happens as a result of increasing number of people with
increased risk of being infected with these diseases (diabetics, people with
lowered immunity etc.).
Because
onychomycosis
can imitate a range of other nail diseases and vice versa, a whole range of nail
diseases can imitate presence of onychomycosis, it is therefore necessary,
considering the difficulty of diagnosis and selection of the following optimal
therapy, to put such affection into the hands of a dermatologist. But what can we do, especially for our lower limbs,
besides hygiene and regular change of socks, if our feet sweat continuously and
bother others and ourselves with unpleasant odor? We can try to use an
ecological preparation. It’s use requires a certain patience and one needs to
follow the instructions, but if the neglected mycosis activates itself into more
distinctive displays, it is anyway necessary, besides visiting the dermatologist
and obtaining relevant therapeutical remedies, to follow the application
instructions of the medicine and time intervals between individual applications.
Neglecting this means running the risk of far more spread and unpleasant
affection. Literature 1.
Sladka J.: Present outcome of European study Achilles and inter-branch
discussions on prescription of system antimyotics in Czech Republic. Medicina
2000, 7:11. 2.
Williams H.C.: The epidemiology of onychomycosis in Britain. Br J
Dermatol 1994, 31 (Suppl.): pg.68 – 74. 3.
Greet D.L.: evolving role of non-dermatophytes in onychomycosis. Int J
dermatol 1995, 34:521-524. 4.
Nielsen P.G.: A comparison between Direct Microscopy and Culture in
Dermatologic Mycotic Material. Mykosen 1981, 24:555-560. 5.
Onsberg P., Stahl D., Veien N.K.: Onychomycosis caused by Aspergillus
terreus. Sabouraudia 1978, 16:39-46 6.
Dvorak J., Weigl E.: Aetiology of onychomycosis and tinea unguium. Acta
Univ Palacki Olomuc, Fac Med 1989, 122:39-44 7.
Barde A.K., Singh S.M.: A case of onychomycosis caused by Curvularia
lunata (Wakker) Boedijn, Mykosen 1983, 26:311-316 8.
Ernst T.-M.: Nagel-Alterariose. Mykosen 1983, 26:553-556. 9.
Kock B.-W.: Temperaturresistenz pathogener Dermatophyten und von Candida
albicans unter Sauna-ahnlichen Bedingungen. Mykosen 1981, 24:33-37. 10.
Mencl K.: Occurrence of foot dermophytes in soldiers on basic military
service. Voj Zdrav Listy 1982, 51:256-260. 11.
Mencl K.: Microscopic skin fungi in soldiers on basic military service.
Tyl Zasob 1982, 32:45-47 12.
Szepes E.: Mykotische Infektionen psoriatischer Nagel. Mykosen 1986,
29:82-84. 13.
Lison E., Clayton Y., Hay R.J., Hope Y., Midgey G., Moore M., Noble W.C.:
The microbiology of foot infection. Mykosen 1986, 29:147-152. 14.
Singh S.M., Barde A.K.: Opportinistic infections of skin and nails by non-dermatophyc
fungi. Mykosen 1986, 29:272-277. |
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