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Kaur T, Bassan MS, Bisht M, Kumar N, Saini P, Hazarika N. Hypothalamus-pituitary-adrenal axis (HPA axis) suppression with inappropriate use of steroids in recalcitrant dermatophytosis - A cross-sectional study. J Family Med Prim Care 2024; 13:2026-2031. [PMID: 38948600 PMCID: PMC11213414 DOI: 10.4103/jfmpc.jfmpc_1330_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 07/02/2024] Open
Abstract
Background Improper use of over-the-counter (OTC) steroid medication has been linked to recalcitrant dermatophytosis. There is proven evidence of HPA axis suppression by the use of long-term oral steroids. This study aims to determine the prevalence and pattern of inappropriate OTC steroid use and its effects on the hypothalamus-pituitary-adrenal (HPA) axis in adults with recalcitrant dermatophytosis. Materials and Methods This cross-sectional study of 2 months was conducted in a hospital setting and included patients of recalcitrant dermatophytosis with a history of OTC steroid use. Clinico-demographic details and basal serum cortisol levels were recorded in all and analyzed. Result Of a total of 103 patients, 59.22% (n = 61/103) were males, and the mean duration of steroid abuse was 17.78 months. About 48.54% (n = 50/103), 3.88% (n = 4/103), and 47.57% (n = 49/103) patients reported the use of topical steroids, oral steroids, and both oral and topical steroids, respectively. Among all the topical steroid users (n = 99), clobetasol propionate 48.48% (n = 48/99), while among oral steroid users (n = 53), prednisolone 45.28% (n = 24/53) were the most commonly used agents, respectively. The morning serum cortisol levels (8-9 AM) were found to be decreased in 42.7% (n = 44/103), with a mean value of 44.28 ± 17.34 μg/dL. Conclusion Improper OTC steroid use in recalcitrant dermatophytosis leads to HPA axis suppression. This highlights the need for intervention from apex health officials.
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Affiliation(s)
- Tanureet Kaur
- Department of Pharmacology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Manbir S. Bassan
- Department of Pharmacology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Manisha Bisht
- Department of Pharmacology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Nitish Kumar
- Department of Dermatology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Poonam Saini
- Department of Dermatology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Neirita Hazarika
- Department of Dermatology, AIIMS Rishikesh, Virbhadra Road, Rishikesh, Uttarakhand, India
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Koher G, Khan A, Suarez-vega G, Meesakul P, Bacani AJ, Kohno T, Zhu X, Kim KH, Cao S, Jia Z. A Comprehensive Insight into Māmaki ( Pipturus albidus): Its Ethnomedicinal Heritage, Human Health Research, and Phytochemical Properties. PLANTS (BASEL, SWITZERLAND) 2023; 12:2924. [PMID: 37631137 PMCID: PMC10459036 DOI: 10.3390/plants12162924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
In Hawaii, the plants P. albidus, P. forbesii, P. kauaiensis, and P. ruber are collectively known as māmaki in ethnomedicine, where P. albidus predominates. Farmed māmaki is becoming increasingly popular in Hawaii and the United States. Māmaki teas (such as bottled Shaka tea) are the dominant product. Historically, māmaki has been utilized for its medicinal properties, promoting well-being and good health through consuming tea made from its leaves, ingesting its fruit, and incorporating it into ointments. Māmaki holds cultural significance among Native Hawaiians and is widely used in ethnic medicine, having been incorporated into traditional practices for centuries. However, the scientific mechanisms behind its effects remain unclear. This review consolidates current knowledge of māmaki, shedding light on its potential therapeutic properties, physical properties, nutritional and mineral composition, and active phytochemicals. We also highlight recent research advances in māmaki's antibacterial, anti-viral, chemopreventive, anti-inflammatory, and antioxidant activities. Additionally, we discuss future prospects in this field.
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Affiliation(s)
- Grant Koher
- Department of Biology, University of North Carolina at Greensboro, Greensboro, NC 27410, USA; (G.K.); (A.K.); (G.S.-v.)
| | - Ajmal Khan
- Department of Biology, University of North Carolina at Greensboro, Greensboro, NC 27410, USA; (G.K.); (A.K.); (G.S.-v.)
| | - Gabriel Suarez-vega
- Department of Biology, University of North Carolina at Greensboro, Greensboro, NC 27410, USA; (G.K.); (A.K.); (G.S.-v.)
| | - Pornphimon Meesakul
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI 96720, USA; (P.M.); (A.-J.B.); (T.K.)
| | - Ann-Janin Bacani
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI 96720, USA; (P.M.); (A.-J.B.); (T.K.)
| | - Tomomi Kohno
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI 96720, USA; (P.M.); (A.-J.B.); (T.K.)
| | - Xuewei Zhu
- Department of Medicine, Wake Forest University School of Medicine, Winston Salem, NC 27101, USA;
| | - Ki Hyun Kim
- School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea;
| | - Shugeng Cao
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI 96720, USA; (P.M.); (A.-J.B.); (T.K.)
| | - Zhenquan Jia
- Department of Biology, University of North Carolina at Greensboro, Greensboro, NC 27410, USA; (G.K.); (A.K.); (G.S.-v.)
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Abdallah BM, Rajendran P, Ali EM. Potential Treatment of Dermatophyte Trichophyton rubrum in Rat Model Using Topical Green Biosynthesized Silver Nanoparticles with Achillea santolina Extract. Molecules 2023; 28:molecules28041536. [PMID: 36838531 PMCID: PMC9965404 DOI: 10.3390/molecules28041536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
Trichophyton rubrum is the most common dermatophyte, and can cause cutaneous infections in humans and animals (dermatophytosis). In this study, we investigated the anti-dermatophytic potential of green synthesized silver nanoparticles using Achillea santolina extract (AS-AgNPs) in an in vitro and in vivo rat model of dermal T. rubrum dermatophytosis (TRD). The green synthesis of AS-AgNPs was performed using A. santolina extract and characterized by UV-VIS spectroscopy, zeta potential, imaging (transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Energy dispersive X-ray analysis (EDX). The antifungal activity of AS-AgNPs was determined by the broth microdilution method, conidial germination, and hyphal growth inhibition. TEM and SEM were used to study the mode of the antifungal action of AS-AgNPs. AS-AgNPs inhibited the growth of T. rubrum with an MIC of 128 μg/mL, and suppressed the conidial germination and hyphal growth by 55.3% 84.6%, respectively. AS-AgNPs caused modified mycelial structures, increased cell membrane permeability, and cell wall damage. AS-AgNPs significantly increase the permeability of the fungal membrane, as revealed by reducing ergosterol biosynthesis. An increase in the intracellular ROS and the induction of apoptosis were also observed during AS-AgNP treatment. In addition, AS-AgNPs reduced the cell wall integrity, as shown by the reduction in the β-(1,3)-d-glucan synthase and chitin synthase activities. AS-AgNPs showed very low toxicity on primary human dermal fibroblasts (HDF) at the MIC. The topical treatment of the infected skin in the TRD rat model with AS-AgNPs showed a significant reduction in the fugal burden after 7 days and a complete clearance of fungal conidia, with a high recovery of epidermal and dermal structures after 14 days, compared to control rats. Interestingly, AS-AgNPs significantly attenuated the infiltrated inflammatory cells, in association with reducing the tissue proinflammatory cytokines including TNF-α, IL-1, IL-6, MOP and IL-17. In conclusion, our data prove AS-AgNPs to be a novel green topical therapy for dermatophytosis caused by T. rubrum.
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Affiliation(s)
- Basem M. Abdallah
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Correspondence: ; Tel.: +966-(013)-589-9430
| | - Peramaiyan Rajendran
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Enas M. Ali
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Botany and Microbiology, Faculty of Science, Cairo University, Cairo 12613, Egypt
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Zhang R, Zhao J, Li L. Metabolic phenotype analysis of Trichophyton rubrum after laser irradiation. BMC Microbiol 2023; 23:24. [PMID: 36681800 PMCID: PMC9862980 DOI: 10.1186/s12866-023-02759-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Biological phenotypes are important characteristics of microorganisms, and often reflect their genotype and genotype changes. Traditionally, Trichophyton rubrum (T. rubrum) phenotypes were detected using carbon source assimilation tests, during which the types of tested substances are limited. In addition, the operation is complicated, and only one substance can be tested at once. To observe the changes of the metabolic phenotype of T. rubrum after laser irradiation, a high-throughput phenotype microarray system was used to analyze the metabolism of different carbon, nitrogen, phosphorus and sulfur source substrates in a Biolog metabolic phenotyping system. RESULTS The strain of T. rubrum used in this study can effectively utilize 33 carbon, 20 nitrogen, 16 phosphorus, and 13 sulfur source substrates prior to laser irradiation. After laser irradiation, the strain was able to utilize 10 carbon, 12 nitrogen, 12 phosphorus, and 8 sulfur source substrates. The degree of utilization was significantly decreased compared with the control. Both groups efficiently utilized saccharides and organic acids as carbon sources as well as some amino acids as nitrogen sources for growth. The number of substrates utilized by T. rubrum after laser irradiation were significantly reduced, especially carbon substrates. Some substrates utilization degree in the laser treated group was higher than control, such as D-glucosamine, L-glutamine, D-2-Phospho-Glyceric Acid, D-glucosamine-6-phosphate, and D-methionine. CONCLUSION Laser irradiation of T. rubrum may lead to changes in the metabolic substrate and metabolic pathway, thus weakening the activity of the strain.
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Affiliation(s)
- Ruina Zhang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, 100050, Beijing, China
| | - Junying Zhao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, 100050, Beijing, China.
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, 100050, Beijing, China.
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Petrucelli MF, Cantelli BAM, Marins M, Fachin AL. The Transcriptional Regulation of Genes Involved in the Immune Innate Response of Keratinocytes Co-Cultured with Trichophyton rubrum Reveals Important Roles of Cytokine GM-CSF. J Fungi (Basel) 2022; 8:1151. [PMID: 36354918 PMCID: PMC9693189 DOI: 10.3390/jof8111151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 04/05/2024] Open
Abstract
Trichophyton rubrum is the most causative agent of dermatophytosis worldwide. The keratinocytes are the first line of defense during infection, triggering immunomodulatory responses. Previous dual RNA-seq data showed the upregulation of several human genes involved in immune response and epithelial barrier integrity during the co-culture of HaCat cells with T. rubrum. This work evaluates the transcriptional response of this set of genes during the co-culture of HaCat with different stages of T. rubrum conidia development and viability. Our results show that the developmental stage of fungal conidia and their viability interfere with the transcriptional regulation of innate immunity genes. The CSF2 gene encoding the cytokine GM-CSF is the most overexpressed, and we report for the first time that CSF2 expression is contact and conidial-viability-dependent during infection. In contrast, CSF2 transcripts and GM-CSF secretion levels were observed when HaCat cells were challenged with bacterial LPS. Furthermore, the secretion of proinflammatory cytokines was dependent on the conidia developmental stage. Thus, we suggest that the viability and developmental stage of fungal conidia interfere with the transcriptional patterns of genes encoding immunomodulatory proteins in human keratinocytes with regard to important roles of GM-CSF during infection.
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Affiliation(s)
- Monise Fazolin Petrucelli
- Biotechnology Unity, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
- Laboratory of Genetics and Molecular Biology of Fungi, Department of Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, Brazil
| | - Bruna Aline M. Cantelli
- Biotechnology Unity, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
| | - Mozart Marins
- Biotechnology Unity, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
- Medicine Course, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
| | - Ana Lúcia Fachin
- Biotechnology Unity, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
- Medicine Course, University of Ribeirão Preto (UNAERP), Ribeirao Preto 14096-900, Brazil
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Development of Indirect ELISA and its evaluation in Comparison with KOH hydrolysis and Fungal culture for the immuno diagnosis of Trichophyton rubrum and Trichophyton mentagrophytes infection in Humans. Acta Trop 2022; 235:106590. [PMID: 35907501 DOI: 10.1016/j.actatropica.2022.106590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/25/2022] [Accepted: 07/05/2022] [Indexed: 11/24/2022]
Abstract
Trichophyton is a keratinophilic fungus that can invade keratinized tissues of humans and cause superficial mycoses called dermatophytosis. The objective of this study was to develop and evaluate indirect ELISA in comparison with gold standard methods such as direct microscopic examination of KOH mounts and fungal culture for the diagnosis of Trichophyton infection in humans. The present investigation reports the production and partial purification of T. rubrum mycelial antigens and production of specific polyclonal antibodies. It also reports the development and optimization of indirect ELISA and evaluation of its potential in comparison with gold standard methods for the diagnosis of Trichophyton infection in humans. The diagnostic sensitivity and specificity of Trichophyton indirect ELISA was 93.75% and 93.33 % respectively. The positive and negative predictive values were high as well, found to be 93.75% and 90.00% respectively indicating usefulness of the assay. In all comparisons, the correlation coefficient (r) value was >0.5 indicating strong correlation between KOH hydrolysis test, fungal culture method and indirect ELISA. A significant correlation coefficient of 0.856 (P < 0.0001) was obtained between indirect ELISA and fungal culture method. This shows a good agreement between fungal culture method and indirect ELISA. The present study clearly shows diagnostic performance of Trichophyton indirect ELISA developed in this study is efficient as fungal culture method for the diagnosis of Trichophyton infection in humans.
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Abuthakir MHS, Al-Dosary MA, Hatamleh AA, Alodaini HA, Perumal P, Jeyam M. Platyphylloside, a potential inhibitor from epicarp of B.aegyptiaca against CYP450 protein in T.rubrum – In vitro and in silico approaches. Saudi J Biol Sci 2022; 29:3899-3910. [PMID: 35844431 PMCID: PMC9280311 DOI: 10.1016/j.sjbs.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022] Open
Abstract
Trichophyton rubrum is one of the major disease causing pathogens in human; mainly it causes tinea pedis, tinea cruris and tinea corporis. Cytochrome P450 which considered to be an important protein that can impact ergosterol biosynthesis pathway. B. aegyptiaca is rich source of secondary metabolites with tremendous medicinal values and it has sweet pulp, leaves with spine, strong seed and oily kernel. The epicarp of the fruit was taken for this study to inhibit T. rubrum using in vitro and in silico techniques. The epicarp portion was extracted using various solvents and water. The anti-dermatophytic activity on T. rubrum of these extracts was assessed utilizing poison plate technique with 5 individual concentrations. The fractioned chloroform extract of epicarp had fully inhibited the growth of T. rubrum at 3 mg/ml. Further, the chloroform extract was subjected to LC-MS analysis, in total, 40 compounds were elucidated. Then, the derived compounds were included for predicting ADMETox properties using Qikprop module. From the analysis 40 compounds were identified to be eligible for docking process. Then the desirable compounds, drug Ketoconazole were subjected to docking analysis using Glide module of Schrödinger. It shows that Platyphylloside has better docking result than other compounds and drug Ketoconazole. Further, MD simulation was carried out for Ketoconazole-Cyp450 and Platyphylloside-CYP450 complexes using Desmond, Schrödinger. MD simulation study also confirmed that the Platyphylloside-CYP450 complex more stable. This study suggests that Platyphylloside may act as potential inhibitor and it could be further subjected to experimental analysis to inhibit the T. rubrum growth.
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Affiliation(s)
| | - Munirah Abdullah Al-Dosary
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - Ashraf Atef Hatamleh
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - Hissah Abdulrahman Alodaini
- Department of Botany and Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh 11451, Saudi Arabia
| | - P. Perumal
- Laboratoire Information Genomique et Structurale (IGS), Marseille, France
| | - Muthusamy Jeyam
- Department of Bioinformatics, Bharathiar University, Coimbatore, Tamil Nadu, India
- Corresponding author.
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Geng Y, Wu W, Li R, Xu J, Gu R, Lu J, Zheng W, Zhao F, Zhang J, Gong J. Founder Effects Contribute to the Population Genetic Structure of the Major Dermatophytosis Pathogen Trichophyton rubrum on Hainan Island, China. Clin Cosmet Investig Dermatol 2021; 14:1569-1577. [PMID: 34737596 PMCID: PMC8558103 DOI: 10.2147/ccid.s329569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022]
Abstract
Background Founder events have been observed among numerous plants and animal species living on oceanic islands due to the geographic separation of these islands and the small amount of original life they harbor. However, there has been little research on the ecological characteristics of pathogenic microorganisms on islands. Trichophyton rubrum ranks the most common isolated dermatophyte causing dermatophytosis in clinic and has become an epidemic strain worldwide in recent decades. Objective To study the phylogenetic characteristics and the distribution pattern of genetic polymorphism of T. rubrum in China, which further provide theoretical basis for the prevention and control of T. rubrum. Methods In the present study, we sequenced and analyzed the genetic characteristics of 204 T. rubrum isolates from Hainan Island and other sites in China. Phylogenetic analysis and genetic polymorphisms were studied based on a total of 41,409 high-quality whole-genome SNPs. Results The majority of the isolates from Hainan Island clustered together. Mixed T. rubrum population differentiation was observed among the strains of different geographical origins. In addition, the genetic diversity (π) of the Hainan isolates was low and showed no significant difference from that of isolates from other sites. Conclusion This study is the first to discuss general ecological and evolutionary principles related to pathogenic fungi. Our findings reveal a founder effect during the origination of T. rubrum on Hainan Island and provide guidance regarding prevention and treatment strategies.
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Affiliation(s)
- Yuanyuan Geng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Weiwei Wu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China.,National Clinical Research Center for Skin and Immune Disease, Beijing, People's Republic of China
| | - Rouyu Li
- Department of Dermatology, Peking University First Hospital, Beijing, People's Republic of China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People's Republic of China.,Research Center for Medical Mycology, Peking University, Beijing, People's Republic of China
| | - Juan Xu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Ruixue Gu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jiejie Lu
- Department of Dermatology, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Wenai Zheng
- Department of Laboratory Medicine, The Fifth People's Hospital of Hainan Province, Haikou, People's Republic of China
| | - Fei Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jianzhong Zhang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jie Gong
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
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Amare HH, Lindtjorn B. Risk factors for scabies, tungiasis, and tinea infections among schoolchildren in southern Ethiopia: A cross-sectional Bayesian multilevel model. PLoS Negl Trop Dis 2021; 15:e0009816. [PMID: 34613968 PMCID: PMC8494366 DOI: 10.1371/journal.pntd.0009816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/16/2021] [Indexed: 11/21/2022] Open
Abstract
Background Skin problems cause significant sickness in communities with poor living conditions, but they have received less attention in national or global health studies because of their low mortality rates. In many developing regions, the prevalence of parasitic skin diseases among schoolchildren is not reported. Previous studies thus have attempted to identify risk factors for these conditions using the frequentist approach. This study aimed to assess the occurrence and risk factors of skin infections among rural schoolchildren in southern Ethiopia by combining a frequentist and a Bayesian approach. Methodology/Principal findings Using three-stage random sampling, we assessed 864 schoolchildren aged 7–14 years from the Wonago district in southern Ethiopia. We detected potential risk factors for scabies, tungiasis, and tinea infections and recorded their hygienic practices and socio-demographic information. The frequentist model revealed a clustering effect of 8.8% at the classroom level and an insignificant effect at the school level. The Bayesian model revealed a clustering effect of 16% at the classroom level and 5.3% at the school level. Almost three-fourths of the sample had at least one type of skin problem, and boys were at higher overall risk than girls (adjusted odds ratio [aOR] 1.55 [95% Bayesian credible interval [BCI] 1.01, 2.28). Risk factors included unclean fingernails (aOR 1.85 [95% BCI 1.08, 2.97]); not washing the body (aOR 1.90 [95% BCI 1.21, 2.85]) and hair (aOR 3.07 [95% BCI 1.98, 4.57]) with soap every week; sharing a bed (aOR 1.97 [95% BCI 1.27, 2.89]), clothes (aOR 5.65 [95% BCI 3.31, 9.21]), or combs (aOR 3.65 [95% BCI 2.28, 5.53]); and living in a poor household (aOR 1.76 [95% BCI 1.03, 2.83]). Washing legs and feet with soap daily was identified as a protective factor for each of the three skin diseases (aOR 0.23 [95% BCI 0.15, 0.33]). Conclusions/Significance We observed high variation in skin problems at the classroom level, indicating the presence of shared risk factors in these locations. The findings suggest the need to improve children’s personal hygiene via health education by schoolteachers and health workers. Skin problems are common disorders in resource poor settings. Scabies and tungiasis are neglected tropical diseases causing significant sickness in communities with poor living conditions. Scabies is dermatosis caused by a burrowing mite, Sarcoptes scabiei var. hominis. Tungiasis is caused by a flea, Tunga penetrans, infesting the skin, usually on the feet or hands. Tinea infection is a fungal dermatophyte infection of the skin and the most common dermatological problem among schoolchildren in Ethiopia, especially tinea capitis. Application of a Bayesian approach to identify possible risk factors for these problems has seldom been used. We found that compared to the frequentist model, the Bayesian model better explained school- and classroom-level variations in skin problems among schoolchildren. Our findings also suggest that transmission of skin infections, especially fungal and scabies infections, frequently occurs in schools and classrooms. We identified several risk factors for these conditions, including low socioeconomic status; unclean fingernails; not washing with soap at least every week; and sharing beds, clothes, and combs. Thus, it is important to improve the personal hygiene of schoolchildren through education. Regular checkups by teachers also can improve skin health and related morbidity in rural schoolchildren in southern Ethiopia.
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Affiliation(s)
- Hiwot Hailu Amare
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
- * E-mail:
| | - Bernt Lindtjorn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
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Thakran P, Agrawal S, Singal A, Verma S, Madhu S. Iatrogenic Cushing's Syndrome in Patients with Superficial Dermatophytosis. Indian Dermatol Online J 2021; 12:237-243. [PMID: 33959519 PMCID: PMC8088179 DOI: 10.4103/idoj.idoj_432_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/07/2020] [Accepted: 09/24/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The epidemic-like scenario of superficial fungal infections in India has been complicated by the prescription of systemic and topical potent steroids. As a result, alarming number of patients are presenting with exogenous Cushing's syndrome. METHODS This cross-sectional study involved 23 patients of superficial dermatophytosis on steroids who presented with clinical features like that of Cushing's syndrome. Their clinical details and laboratory investigations including fungal culture and serum cortisol, were recorded on a pre-designed proforma. RESULTS There were 23 patients (14 males and 9 females) with mean age of 29.47 ± 15.5 years, majority with extensive tinea cruris and corporis. All of them received oral (Betamethasone) or parenteral corticosteroids along with potent topical steroids (clobetasol propionate and betamethasone valerate) for at least two months. In majority (56.5%), treatment was prescribed by unqualified medical practitioners and in the rest by alternative medical practitioners. Striae, buffalo hump, hirsutism were observed in 16 (69.5%), 15 (65.2%), 13 (56.5%) patients, respectively. Serum cortisol estimation revealed low levels and ranged from 0.66 to 6 μg/ml with a mean of 1.53 ± 1.27 μg/ml (normal 7-25 μg/ml). CONCLUSIONS Corticosteroids are life saving for many dermatological diseases; their injudicious use (topical, oral, and parenteral) for prolonged periods in the treatment of superficial dermatophytosis can lead to Cushing's syndrome.
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Affiliation(s)
- Priyesh Thakran
- Department of Endocrinology and Metabolism University College of Medical Sciences and GTB Hospital (University of Delhi), Delhi, India
| | - Sonia Agrawal
- Department of Endocrinology and Metabolism University College of Medical Sciences and GTB Hospital (University of Delhi), Delhi, India
| | - Archana Singal
- Department of Endocrinology and Metabolism University College of Medical Sciences and GTB Hospital (University of Delhi), Delhi, India
| | - Shyam Verma
- Department of Endocrinology and Metabolism University College of Medical Sciences and GTB Hospital (University of Delhi), Delhi, India
| | - S.V. Madhu
- Department of Endocrinology and Metabolism University College of Medical Sciences and GTB Hospital (University of Delhi), Delhi, India
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Putative Drug Target Identification in Tinea Causing Pathogen Trichophyton rubrum Using Subtractive Proteomics Approach. Curr Microbiol 2020; 77:2953-2962. [DOI: 10.1007/s00284-020-02114-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 07/04/2020] [Indexed: 12/24/2022]
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Novickij V, Grainys A, Švedienė J, Paškevičius A, Novickij J. Controlled inactivation of Trichophyton rubrum using shaped electrical pulse bursts: Parametric analysis. Biotechnol Prog 2016; 32:1056-60. [PMID: 27071774 DOI: 10.1002/btpr.2276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 04/07/2016] [Indexed: 01/15/2023]
Abstract
The dermatophytes infect the skin by adherence to the epidermis followed by germination, growth, and penetration of the fungal hyphae within the cells. The aim of this study was to investigate the efficacy of the pulsed electric fields (PEF) of controlled inactivation of Trichophyton rubrum (ATCC 28188). In this work, we have used bursts of the square wave PEF pulses of different intensity (10-30 kV/cm) to induce the irreversible inactivation in vitro. The electric field pulses of 50 µs and 100 µs have been generated in bursts of 5, 10, and 20 pulses with repetition frequency of 1 Hz. The dynamics of the inactivation using different treatment parameters were studied and the inactivation map for the T. rubrum has been defined. Further, the combined effect of PEF with the antifungal agents itraconazole, terbinafine, and naftifine HCl was investigated. It has been demonstrated that the combined effect results in the full inactivation of T. rubrum colony. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1056-1060, 2016.
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Affiliation(s)
- Vitalij Novickij
- High Magnetic Field Inst., Vilnius Gediminas Technical University, Vilnius, 03227, Lithuania
| | - Audrius Grainys
- High Magnetic Field Inst., Vilnius Gediminas Technical University, Vilnius, 03227, Lithuania
| | - Jurgita Švedienė
- Laboratory of Biodeterioration Research, Nature Research Centre, Vilnius, 08412, Lithuania
| | - Algimantas Paškevičius
- Laboratory of Biodeterioration Research, Nature Research Centre, Vilnius, 08412, Lithuania.,Laboratory of Microbiology of the Centre of Laboratory Medicine, Vilnius University Hospital Santariškių Clinics, Vilnius, Lithuania
| | - Jurij Novickij
- High Magnetic Field Inst., Vilnius Gediminas Technical University, Vilnius, 03227, Lithuania
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