Ichthyotherapy as alternative treatment for patients with psoriasis: a pilot study

Animal healer for refractory diseases: Myth or reality?

A vast amount of knowledge has been acquired through human activities such as farming, hunting, and fishing. Throughout history, humans have utilized living creatures for disease treatment, relying on the natural world's healing powers. The special "healers" may be able to treat patients via the power of nature. However, there was no systematic introduction or summary of these treatments. Therefore, we conducted a literature review based on PubMed, Google Scholar, Web of Science, Scopus, CNKI and WanFang DATA. Here, we defined this unique method as "animal healer" and six common kinds of animal healers were reviewed. These are fish therapy, pet therapy, worm therapy, leech therapy, maggot therapy, and bee therapy. According to the different characteristics of healers, treatment methods mainly included bite, parasitism, contact and communication. With the advantages of green and effectiveness, animal healers have great therapy potential against a variety of refractory diseases. The main purpose of this review is to draw people's attention to animal healer, promote it to become a possible clinical treatment strategy, and make further exploration in species cultivation, mechanism research, animal welfare, standard setting, safety evaluation and other aspects. In the future, animal healers will play an increasingly important role in medicine and hopefully solve more medical problems and dilemmas.

Fish Pedicure: A Risky Aesthetic Treatment for Tourists

Fish pedicure is considered to be an aesthetic treatment, first conceived in Turkey, in Kangal Hot Springs. These hot waters are rich in two species of fish of the Cyprinidae family that feed on the stratum corneum layer of patients with psoriasis. This treatment was later adapted to many spa resorts for "fish pedicure." In this article, we performed a review of the skin infections already reported, explaining why this procedure, performed usually during summer holidays by tourists, is not risk free and should be discouraged by health workers.

Fish Pedicure: Review of Its Current Dermatology Applications

Ichthyotherapy or fish pedicure is a unique form of biotherapy in which the species Garra rufa or doctor fish is used to exfoliate the skin and potentially aid in healing diseases, such as psoriasis. The practice has gained popularity since its origins in Kangal Fish Spring in Turkey; however, safety concerns, especially among immunocompromised patients, remain. This article reviews the studied dermatological benefits of ichthyotherapy and theorized mechanisms of action. Included are cases examining both infectious and noninfectious complications of this procedure. This review highlights the need to educate susceptible patients about possible adverse effects and the need for more studies assessing this procedure.

The Dignity of Kangal Fish in the Context of the Swiss Animal Protection Act

Simple Summary

Since 2008, the Swiss Animal Protection Act protects not only the welfare but also the dignity of animals. This article explains the concept of the dignity of animals in the context of the Act. Weighing of interests is applied in a specific situation to answer the question of whether the dignity of the animal is respected or not. With this method, the strain imposed on the animal and the interests involved in the situation are evaluated and compared. The seven-step model for the weighing of interests is explained in detail. How the weighing of interests deals with practical questions is shown with the example of kangal fish used for therapeutic or recreational purposes.

Abstract

Since 2008, the Swiss Animal Protection Act (AniPA) protects not only the welfare but also the dignity of the animal. Weighing of interests plays a crucial role in the implementation of the dignity concept. This article outlines the concept of the dignity of animals and explains the method of weighing of interests in the context of the AniPA. The ‘Dignity of the Animal’ study group (DSG) of the Federal Food Safety and Veterinary Office (FSVO) has disputed the implementation of this novel concept in animal welfare and has developed a model procedure to ensure that weighing of interests in the context of the AniPA is carried out correctly and in a standardized way. Weighing of interests is performed in seven steps: 1. Describing the aim; 2. presentation of the facts; 3. assessing suitability; 4. assessing necessity; 5. identifying and assessing strain; 6. identifying and assessing interests; and 7. comparing strain vs. interests. The application of the model is shown with the example of kangal fish used for therapeutic or recreational purposes. It shows how the outcome of the weighing of interests will differ for the same setup depending on the nature of interests involved.

Psoriasis treatment: Unconventional and non-standard modalities in the era of biologics

Psoriasis is a potentially debilitating inflammatory dermatosis affecting 0.2%-4.8% of the population worldwide causing a significant occupational, personal or psychosocial morbidity to these patients for life. The basic aim of psoriasis therapy is to control the disease to maximum possible extent and improve the patient’s quality of life. Management of triggers for flare-ups, lifestyle modifications, and dietary supplements are often recommended. Intermittent or rotational therapy with frequent alterations in treatment options is usually needed to reduce toxicity of anti-psoriatic drugs in the absence of safer alternatives. Currently, several biological agents categorized as either T-cell targeted (e.g., Alefacept, Efalizumab) or cytokine modulating (e.g., Adalimumab, Infliximab, Etanercept) are available for treating severe psoriasis. However, their high cost is often precluding for most patients. The usefulness of systemic (methotrexate, cyclosporine, acitretin or several other therapeutic agents) or topical (tar, anthralin, corticosteroids or calcipotriol ointments, phototherapy with or without psoralens) therapies has been well established for the management of psoriasis. The literature is also replete with benefits of less used non-standard and unconventional treatment modalities (hydroxycarbamide, azathioprine, leflunomide, mycophenolate mofetil, isotretinoin, fumarates, topical calcineurin inhibitors, peroxisome proliferator-activated receptors agonists, statins, sulfasalazine, pentoxifylline, colchicine, grenz ray therapy, excimer laser, climatotherapy and balneophototherapy, peritoneal dialysis, tonsillectomy, ichthyotherapy, etc.). These can be used alternatively to treat psoriasis patients who have mild/minimal lesions, are intolerant to conventional drugs, have developed side effects or achieved recommended cumulative dose, where comorbidities pose unusual therapeutic challenges, or may be as intermittent, rotational or combination treatment alternatives.

The microbiological quality of water in fish spas with Garra rufa fish, the Netherlands, October to November 2012

In fish spas, clients may submerge their hands, feet or whole body in basins with Garra rufa fish, for dead skin removal. Skin infections may result from using these spas, transmitted from fish to clients, through either fish or water, or from client to client. The microbiological water quality was determined in 24 fish spas in 16 companies in the Netherlands through analysis of a single water sample per fish spa. Water samples were tested for the presence of Aeromonas spp., Vibrio spp., Pseudomonas aeruginosa, nontuberculous mycobacteria, and faecal indicator bacteria by using standard culture methods. The majority of the examined fish spas contained Aeromonas spp. (n?=?24), P. aeruginosa (n?=?18), Vibrio spp. (n?=?16) including V. cholerae non-O1/O139 and V. vulnificus, and several rapid growing Mycobacterium spp. (n?=?23) including M. fortuitum, M. conceptionense, M. abscessus and M. chelonae. Faecal contamination of the fish spa water was low. Based on the detected concentrations of Aeromonas spp., Vibrio spp., and P. aeruginosa, the detected Mycobacterium spp., and the health implications of these bacteria, the health risk from using fish spas is considered limited for healthy people with an intact skin and no underlying disease.

Mortality of therapeutic fish Garra rufa caused by Aeromonas sobria

OBJECTIVE

To investigate a case of mass mortality of Garra rufa (G. rufa) from a fish hatchery farm in Slovakia.

METHODS

Causative bacterial agent was swabbing out of affected fish skin area and subsequently identified using commercial test system. Antibiotic susceptibility was determined by the disk diffusion method.

RESULTS

Infected G. rufa was characterized by abnormal swimming behaviour, bleeding of skin lesions and local haemorrhages. Despite of using recommended aquatic antibiotic treatment no improvement was achieved and Aeromonas sobria (A. sobria) was identified as a causative agent of fish mortality. Due to massive fish mortality, antibiotic susceptibility of pure isolated culture of A. sobria was evaluated employing eight antibiotics against human infections. A. sobria was resistant only against one antibiotic, namely ampicilin.

CONCLUSIONS

These results indicate that A. sobria can act as a primary pathogen of G. rufa and may be a potential risk factor for immunodeficient or immunoincompetent patients during the ichthyotherapy.

Staphylococcus aureus infection of the feet following fish pedicure

We report a case of Staphylococcus aureus infection of the feet that appeared after a "fish pedicure" (immersion of the feet in a tank with the fish Garra rufa, that nibbles off dead skin). Clinical picture was characterized by maceration, purulent discharge, scales, crusts, itching and burning sensation. Bacteriological examinations were positive for Staphylococcus aureus. Mycological examinations were negative. The patient was successfully treated with ciprofloxacin. Only one case of skin foot infection after fish pedicure was reported so far. Fish pedicure can be a potentially dangerous procedure in immunocompromised or diabetic patients.

Isolation of Streptococcus agalactiae and an aquatic birnavirus from doctor fish Garra rufa L

Background

The doctor fish, Garra rufa, has become increasingly popular as a treatment for skin disorders and for pedicures in recent years. Despite this there is very little information available regarding the welfare of these fish and the range of potential pathogens they may carry. In this study, a group of fish suffering from post-transport mortalities were examined and the isolated pathogens identified.

Findings

Group B Streptococcus agalactiae was isolated from kidney swabs of the fish and found to be resistant to a number of antibiotics. In addition to this, a fish virus belonging to the aquabirnavirus group, serogroup C was isolated for the first time in Ireland. However, no clinical signs of disease typical of bacterial or viral infections were observed in any fish examined.

Conclusions

As no clinical signs of disease attributable to either of the pathogens identified were found it was concluded that the mortalities were most likely due to transport related stress exacerbated by the presence of the pathogens. Further work is required to assess the suitability of current transport strategies and to examine the potential risk associated with the transport of live ornamental fish.

Methicillin-resistant Staphylococcus aureus foot infection after fish pedicure

Fish pedicure has become a popular cosmetic procedure involving immersion of the feet in a tank with freshwater fish (Garra rufa) that nibble off dead skin. There are concerns about the potential transmission of pathogens, but no cases of infections after this procedure have been published so far. We present a patient who developed foot infection with methicillin-resistant Staphylococcus aureus (MRSA) after fish pedicure.

Climatotherapy of psoriasis

In the era when biological treatments for psoriasis are gaining more and more popularity, climatotherapy represents a safe and efficient alternative to the conventional therapeutic modalities. Climatotherapy comprises alternative treatment methods, which are based on the healing capacities of natural resources. This paper provides the reader with relevant information on the different climatotherapeutic methods, the intimate mechanisms of their action, and the cumulated clinical experience in the treatment of psoriasis. The positive effect of thalassotherapy for psoriasis has been known since ancient times. However, in the past decades a number of controlled studies revealed the efficacy of thalassotherpay in the treatment of psoriasis. Herein, it is exemplified on the experience in the centers at the Dead Sea and the Black Sea coast. Originating from Europe, balneo- and spa therapy are becoming popular alternatives for psoriasis treatment worldwide. A short review on the centers profiled for psoriasis therapy is provided. The unique sites of Blue Lagoon in Iceland and Kangal in Turkey are selected in this paper. Additionally, alternative nature-based treatments for psoriasis such as high mountain climatotherapy and naphtalotherapy are discussed.