Dermatophytes: Identifying prevention techniques and

treatments for fungal skin infections

Aaron MillsBio 594-Mycology

November 25, 20136:30 p.m.

Agenda

• Why we should be concerned

• Simple prevention techniques

• Advanced prevention techniques

• Treatments

• Potential for future research

•Out of sight out of mind….Right?

•Can be debilitating

•Widespread globally and economically significant•Treatments are expensive!

Why should we care?

•The best defense is offense.

•Simple prevention methods

•Keep skin as clean and dry as possible

•Thoroughly wash hair and body with shampoo

and soap

•Keep toe and finger nails short

•Change your underwear and socks!

•Wear loose fitting clothing

Prevention the Simple way

The types of socks worn is important

•Be smart about footwear choices

•Rotate shoes

•Apply anti-fungal powders as precautions

•No sharing

•Sandals in communal areas

Boiling water is the most effective method for prevention

More Simple Prevention

Heavy Metals•Can be used at low concentrations (makes them safe)

•Inactivate intercellular proteins

• Silver is primary metal•Also use copper, zinc, and cobalt

Advanced Prevention Methods

•Lowered fungal loads by 4 log10 CFU ml-1 with and without detergent

•Spin cycle important step

The Silver Ion Laundry Machine

With Detergent Without Detergent

Jung et. al 2007

•Used to reduce fungal loads in patients

•Potential preventative use

•Moisture activated

Copper Lined Socks

Gargiulo et al. 2012

•Two types of agents •-static •–cidal

•Antimicrobial clothing is a biocide•QAC- Quanternary ammonium compounds•PHMB- Polyhexamethylene Biguanides

Antimicrobial Clothing

QAC PHMB

Hammer et al. 2012

Antimicrobial Clothing

•Effectiveness

•Clothing that these compounds are added to include: sportswear, socks, shoe liners, and lingerie

•Concerns with antimicrobial fabric

Two Treatment types:•Passive treatment

•Effectiveness issues

•Direct treatment with drying heat•Most effective treatment

Ozone Gas

Gupta and Brintnell 2013

Ozone Gas

•Potential heat resistance issue with with direct treatment

•Issues with current technology

Treatments•Treatment for existing infections involve applications of various antifungal creams and powders.

•Tolnaftate, Clotrimazole, and Miconazole are some common active ingredients

•Oral prescriptions can be given in severe cases

•Effectiveness depends on the PATIENT•Precautions for people with infections

•Cover infected areas•Change bed clothing and linens frequently •Dry infected area last

•Need to increase public awareness and sense of importance•Research to improve and refine preventative measures

The Future

Summary

•Dermatophytes are a common yet under appreciated fungal infection among the global populations

•Simple preventative measures can help prevent infection and spread•Personal hygiene, drying shoes, changing socks, etc.

•Advance prevention methods such as heavy metal treatments, antimicrobial clothing, and Ozone gas treatments are available

•General treatments are in cream or powder forms with oral medication for severe cases

•Future studies and research should focus on access and affordability of advanced treatments and increasing public awareness

References•Achterman, R.R. & White, T.C. (2012). A foot in the door for dermatophyte research. PLOS pathogens, 8(3), 1-4. Retrieved from

EBSCOhost Academic Search Complete database.•Field, L.A. & Adams, B.B. (2008). Tinea pedis in athletes. International Journal of Dermatology, 47, 485-492. Retrieved from

EBSCOhost Academic Search Complete database.•Gao, Y. & Cranston, R. (2008). Recent advances in antimicrobial treatments of textiles. Textile Research Journal, 78(1), 60-72.

doi:10.1177/0040417507082332 •Gargiulo, M.E., del Camen Elías, A. & Borkow, G. (2012). Analysis of the effect of wearing copper oxide impregnated socks on

inea pedis base on “before and after” pictures- a statistical follow-up tool. The Open Biology Journal, 5, 17-22. . Retrieved from EBSCOhost Academic Search Complete database.

•Gupta, A.K. & Brintnell, W.C. (2013). Sanitizaiton of contaminated footwear from onychomycosis patients using ozone gas: a novel adjunct therapy for treating onychomycosis and tinea pedis?. Journal of Cutaneous Medicine and Surgery, 17(4),

243-249. Retrieved from EBSCOhose Academic Search Complete database.•Hammer, T.R., Mucha, M. & Hoefer D. (2012). Dermatophyte susceptibility varies towards antimicrobial textiles. Mycoses, 55, 344- 351. doi: 10.1111/j.1439-0507.2011.02121.x•Jang, K.A., Chi, D.H., Choi, J.H., Sung, K.J., Moon, K.C. & Koh, J.K. (2000). Tinea pedis in Korean children. International Journal

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Academic Search Complete database.•Neji, S., Makni, F., Cheikhrouhou, F., Sellami, A., Sellami, H., Marreckchi, S., …, & Ayadi, A. (2008). Epidemiology of dermatophytoses in Sfax, Tunisia. Mycoses, 52, 534-538. doi: 10.1111/j.1439-0507.2008.01651.x•Sahin, I., Kaya, D., Parlak, A.H., Oksuz, S. & Behcet, M. (2005). Dermatphytoses in forestry workers and farmers. Mycoses, 48,

260-264. Retrieved from EBSCOhost Academic Search Complete database.•Tostil, A., Hay, R. & Arenas-Guzmán, R. (2005). Patients at risk of onchomycosis- risk factor identification and active prevention.

Journal of European Academy of Dermatology and Venereology, 19, 13-16. doi: 10.1111/j.1468-3083.2005.01282.x