A Review on the Study of Pathogenesis and Herbal treatment of Tinea versicolor

 

Anuraag M. Rai¹*, Bhavik Chauhan²

¹Research Scholar, Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Vadodara.

²Assistant Professor, Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Vadodara.

 

ABSTRACT:

Tinea Versicolor are fungal infections caused by micro-organism Malassezia furfur. The infections led to symptoms such as white and black patches onto the skin, however, the infections can be treated by using antifungal preparations. The disease is not severe but on long term, if left untreated, may lead to various skin disorders. In this article, a brief study of the disease as well as the nature of the micro-organism has been shown. Along with the full description of the disease such as pathophysiology and diagnosis, a novel approach for its treatment using the natural herbs has been discussed which may be the limelight of this paper. Herbs which are inhabitated in nature having anti-fungal activity has been thoroughly studied along with its legit researches and experiments.

 

 

 

INTRODUCTION:

Tinea versicolor is a common fungal infection which causes white or dark patches similar that of Vitiligo, however the pattern in which the infection starts may be differ to that of vitiligo.

 

Definition:

Tinea versicolor also known as pityriasis versicolor is a fungal or yeast skin rash. The infection is characterized by the formation of white or dark patches on the skin such that of vitiligo but, however, the pattern of the white patches may differ to that of vitiligo^1.

 

Etiology:

Tinea Versicolor is caused by fungus called Malassezia furfur and infection normally occurs due to excessive sweating. This type of infection is more to occur on hot and humid climates.

 

Basically, the new born child is more prone to the infection. Since these fungi are normally present in the environment, chances of infection are more^2.

 

Pathophysiology:

Malassezia metabolizes various fatty acids, such as arachidonic or vaccenic acids, and azelaic acid is released as one of the metabolites. This azelaic acid inhibits the action of the dopa-tyrosinase enzyme, which blocks the passage of tyrosine to melanin and consequently results in the appearance of hypochromic spots. This result to the formation of macules (discolored skin) those are normally non-irritable and non-inflammatory³.

 

Mode of Infection:

The fungus Malassezia furfur firstly attached to the skin through its propagules and then starts with the formation of hyphae which produces azelaic acid (an acid with a bleaching effect) and causes white or dark patches on the skin. The patches are normally seen on face, neck and trunk³.

 

Development of infection:

Due to the lipophilic nature of the yeasts, the fatty acids on the human skins favor the development of this yeast. Since the amount of the fatty acids is less in childhood therefore only few species of Malassezia are present on the skin.

 

However, during adolescence, the amount of fatty acid secreted by the skin glands is high due to the action of sex hormones. Thereby infection can happen any time. There are several factors that may aid to the development of infection. Some of them are as follows:

1.     Development of yeast is facilitated by the application of oil and greasy creams, that provides a substrate to the yeast for its growth.

2.     Increases production of azelaic acid by fungus is due to the exposure to sunlight that facilitates the metabolism of fungus.

3.     Drugs such as corticosteroids in larger quantities, induces the growth of yeast metabolites⁴;

4.     The basic problem is the Malnutrition, which favors the development of this condition⁵ and

5.     Hyperhidrosis (excessive sweating), which is more frequently associated with hyperchromic lesions in areas near the natural folds of the body⁶.

 

Diagnosis:

Tinea versicolor may be detected by using Wood's lamp, in which the white patches flouresce when exposed to Wood's lamp⁷ Wood’s lamp is a source of long wave ultraviolet light that can be used to detect the fluorescence on the skin and hair which is a feature of some dermatophytes. In simple words when fungus is subjected to Wood’s lamp, the fungus glows.

 

Management of Disease:

In the current scenario there are various anti-fungal synthetic drugs available in the market. Here are the list of anti-fungal agents^8.

 

Table 1- List of Anti-fungal agents

 

These anti-fungal agents are highly effective on Tinea versicolor however there is one drawback i.e., regaining of the actual skin tone⁹. The most widely used is the clotrimazole cream that has a promising potent action¹⁰. As we have discussed earlier M. furfur produces white or dark patches on skin, even though we are able to kill the fungi and eliminate it completely, however the patches on the skin remains for a long time. Sometimes the patches may disappear after a week or a month and sometimes it remains there for a long time. In short, the synthetic anti-fungal agents are only able to kill but do not have any contribution on bringing the skin tone back¹¹.

 

There are many herbs that are not only able to eliminate but also helps in bring the original skin tone back. These are some lists of herbs that are having a good anti-fungal activity.

 

1.     Oregano

Among all the herbs, oregano is considered to be the most potent anti-fungal herbs. The main active constituent of oregano includes thymol and carvacrol which is basically reported to have a potent anti-fungal activity. Besides these the oregano flakes are used as flavoring agents in food industries. The oil derived from the oregano leaves possess anti-fungal activity. The anti-fungal activity of oregano oil has been proved ⁽¹²⁾.

 

Material and Methods used for the determination of anti-fungal activity:

Aerial parts of Origanum Vulgare were collected, washed and dried naturally for 1-2 days and were powdered. The powder was then extracted using methanol by applying Soxhlet extraction technique. The methanolic extract obtained was then carried out for the antifungal activity¹³.

 

Microbial cultures of Four different fungal species (Pencillium cryogeneum, Candida albicans, Aspergillus fumigatus and Saccharomyces cerevisiae) were used for the determination of anti-fungal activity. Amphotericin was used as a reference standard anti-fungal agent and the inhibition effect of the methanolic extract of O. vulgare was then compared against the standard.

 

RESULTS:

The tests result showed that the methanolic extract of O. vulgare found to have a prominent anti-fungal activity against all the four fungal species included in the test.

 

2.     Tea tree:

Tea tree oil is being reported to have a good antibacterial activity such as E. coli. In addition to anti-bacterial activity, tea tree oil also possesses anti-fungal activity¹⁴.

 

The main active constituents of TTO include 1-8 cineole, terpinen-4-ol, alpha terpineol and gamma terpinen. It has been reported that TTO shows an active potential anti-fungal activity against Candida species¹⁵.

 

Methods used for the determination of Anti-fungal activity:

In this assay, eight different fungal species [Aspergillus ochraceus (ATCC 12066), Aspergillus fumigatus (human isolate), Aspergillus niger (ATCC 6275), Aspergillus flavus (ATCC 9643), Penicillium funiculosum (ATCC 6275), Penicillium ochrochloron (ATCC 9112), Fusarium verticiloides and Trichoderma viride (IAM5061)] were used. MIC and MFC (minimum fungicidal concentration) were determined by using the microdilution technique. Fluconazole (a commercial fungicide) was used as a control one.

 

RESULT AND DISCUSSION:

It was observed that all the eight fungal species were prominently susceptible to Tea tree oil respectively. Out of eight species Candida sp. was found to be more susceptible as compared to the other species.

 

3.     Dill seed extract:

Dill has been recently reported to possess anti-fungal activity. A research based on the activity of Dill seed aqueous extract shown a positive impact against the Malassezia species namely M. furfur¹⁶. The active chemical constituent found in Dill i.e., mainly the Carvone proves to be a potent anti-fungal entity.

 

MATERIAL AND METHODS:

Malassezia furfur was first isolated and identified from the patient being diagnosed to have tinea versicolor ⁽¹⁷⁾. This research was based specially on a comparison view. Along with dill seed extract, 17 other essential oils that have previously determined to have an anti-fungal activity has been included so that the activity of the dill seed extract can be evaluated and quantified.

 

Table 2- List of herbs taken in comparison with the dill seeds extract

 

Fig-1 Diameter of zone of inhibition by essential oils

 

Fig-2 Diameter of zone of inhibition by Dill

 

RESULT:

The comparison between inhibition effect of the 13 essential oils and the dill extract shows that Dill seed extract exerts an optimum inhibition effect against the Malassezia species. In (fig. 1) it shows the highest zone of inhibition is exerted by garlic oil and the lowest was exerted by chamomile oil. And fig-2 shows the diameter of inhibition exerted by the dill seed extract. The figure clearly shows that the fungus M. furfur is highly susceptible to dill seed extract. The above study on the basis between comparison and efficacy, it was concluded that M. furfur is susceptible to the dill seed extract. By taking this research into account one can develop a formulation including dill seed extract or dill seed oil which may replace other existing synthetic anti-fungal drugs that produces a negative side effects and toxicities.

 

Other Herbal drugs having Anti-fungal Properties:

Apart from these herbs, there are other many herbs that has been reported or used traditionally by the tribal people as a treatment for many fungal infections such as ringworm, candida albicans and sepsis^18,19.

 

Table 3- List of anti-fungal herbs

Considering ethno-botanical and ethno-pharmacological literatures and researches there are still many herbs yet to explore that may possess an anti-fungal activity. Some of the herbs are been listed below that has been already researched and reported for its fungal activity^20-23.

 

CONCLUSION:

The overall review concludes that besides the anti-fungal drugs and its formulation already available in the market there are many herbs that replicates the same action provided by the synthetic drugs. It will not only reduce the toxicity of the formulation but also provide a beneficial effect on the skin. The attempt to develop an anti-fungal herbal cream taking into account all the available herbs being reported to pertain anti-fungal activity would be more or less successful but the toxicity to the skin will be reduced.

 

REFERENCES:

1.      Pityriasis versicolor. Grigoriu D, Delacrétaz J, Borelli D. 1988, Traité de Micologie Médicale, pp. 177-90.

2.      Human infections due to Malassezia spp. Clin. MJ, Marcon and DA, Powell. 1992, Vol. 5, pp. 101-119.

3.      Pathogenesis of dermatophytosis and tinea versicolor. Luis J. Mendez-Tovar, MD. 2010, Clinics in Dermatology, Vol. 28, pp. 185-189.

4.      Skin diseases associated with Malassezia species. Gupta AK Et. Al., 2004, J Am Acad Dermatol, Vol. 51, pp. 785-98.

5.      Genetic susceptibility in pityriasis versicolor. Hafez M, el-Shamy S. 1985, Dermatologica, Vol. 17, pp. 86-8.

6.      Tinea versicolor: susceptibility factors and experimental infection in human beings. RC., Burkhe. 1961, J Invest Dermatol, Vol. 36, pp. 389-402.

7.      Wood’s light in dermatology. Asawanonda P, Taylor CR. 1999, International Journal of Dermatol, Vol. 38, pp. 801-7.

8.      al, Koushlesh Kumar Mishra et. Medicinal Plants having antifungal Properties. [book auth.] A.R. Hassan. Medicinal Plants- Use in prevention and treatment of diseases. 2020, 6.

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15.   Effects of Tea tree oil in Escherichia Coli.  J.E. Gustasfson Et. Al. 1998, Letters in applied Microbiology, Vol. 26, pp. 194-8.

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17.   Antibiotics against Plant disease. Laboratory and plant house Survey. Pridham TG, Lindenfelser LA, Shotwell OL. 46, 1956, Phytopathol, pp. 568-75.

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Received on 22.03.2021         Modified on 18.08.2021

Accepted on 18.10.2021       ©A&V Publications All right reserved