Kontaktní spojení
Kontaktní adresa
Výrobce : Bio Agens Research and Development - BARD, s.r.o.
Tyršova 180,
43901 Černčice,
IČ: 27311392
Tel: 728 814 202
Fax: 220 560 428
e-mail: raklimes1@centrum.cz
Pre lekárou
DERMA 1/4 ,2001, December 8-12
By the nature against dermatomycosis
KAREL MENCL
Abstract
BIODEUR is a biopreparat which is known as a cosmetics suitable for suppresssion of smell symptomps as well as for destriction of the hidrotic syndrom and tinea of feet. The efficacy of this preparat was evaluated in this work in 69 patients. In every patient was done the mycological examination of the scale from interdigital space as well as nails. The most frequent agent were Trichophyton rubrum (17,4%) and Trichophyton mentagrophytes (8,7%). In 39 patients (56,5%) was positive only microscopic examination. Into the group for investigation of the biopreparat activity were involved only the patients with the positive laboratory examination of dermatomycosis. Evaluation of efficacy was one month after initial aplication of the biopreparat. Smell symptoms were eliminated in 78,6% of patients (n=42), improvement was in 19% of patients. The biopreparat was without any effect (2,4%) only in one patient. The hidrotic syndrom was eliminated in 67,4% (n=43), improved in 27,9% and without any change in 4,7% patients. In the case of tinea pedis, tinea interdigitalis were the symptoms of the disease eliminated in 82,8% of patients (n=58) and improved in 17,2% cases. The effect of iopreparat on onychomycosis was evaluated as subjective improvement of the disease, growing up of healthy nail and improvement of patients compliance. This positive effect was in 72,9% persons (n=59) with onychomycosis and in 27,1% patients was not present any improvement. During the treatment with the biopreparat did not occur any negative side effects as well as impairment of disease.
Key words: tinea pedis, tinea interdigitalis, onychomycosis, hidrotic syndrom, smell symtoms, biopreparat BIODEUR
Introduction
Our attitude to health-related problems and the way we deal with them often does not reflect the fact that we are a part of nature. We originated from nature and still can rely on her as our powerful ally, regardless of the fact that we have been doing our best to devastate her. Very often it is quite enough just to copy things that nature created and verified thousands of years ago and have developed and improved over centuries. This is also the case of myco-parasitic fungi, which may apparently be used as natural potential for eliminating odorous symptoms of human feet and dermatomycoses in this localisation.
Waiting rooms of dermatologists are still full of patients suffering from dermatological diseases caused by microscopic fungi and their adnexas, in spite of the fact that their significance has lately been slightly overshadowed by the much more serious opportune mycotic infections that cause organ and systemic diseases and their malign activities in tissues and organs put into risk the lives of the affected patients. These infections are undoubtedly very serious, but we should not neglect our skin either, because it is also an important human organ.
Most dermamycoses affect lower limbs/extremities, namely as mycosis of interdigital spaces /tinea interdigitalis/ and nails /onychomycosis, tinea unguium/; the neglected or overlooked mycosis of interdigital spaces is in fact the most frequent origin of the infection of toenails, in epidemiological terms. The disease itself belongs to the category of contact diseases. Men are most likely to catch this disease when they are in the military service /1, 2/, other people might be infected by wearing someone else's shoes, from a mat in a shared washroom or shower room, in swimming pools etc. The causal relation of the contagion may also originate from a recent phenomenon labelled as "obsession with a healthy life", which brings more and more people to swimming pools, saunas and other sport facilities. In connection to this we should bear in mind the fact that even a heated sauna does not necessarily guarantee a clean and healthy environment, free of mycological infection /3/.
Foot skin disease is catalysed mainly by wearing impervious or almost impervious shoes, by foot perspiration and insufficient care of soles which are strained so much. The originating warm moisture macerates the skin, which subsequently becomes more sensitive to minor traumatising interventions and the environment also enables the further proliferation of microbial microbial flora, especially Gr- bacteria /4/. The whole process, apart from the unpleasant odour, also prepares suitable environment for the subsequent take-over by microscopic fungi. If you underestimate the process at such an early stage, the infection may subsequently spread to the nail disks as well.
"Biodeur" bio-preparation
I have been working in the field of medical mycology for more than 20 years and over these years I have become almost obsessed with this issue. I was therefore interested in the annotation of one generally available cosmetic bio-preparation which caught my eye in one pharmacy and which claimed that the preparation was able to successfully eliminate odorous symptoms and feet fungi. Ever since my military service I have suffered from recurring interdigital mycosis triggered by foot perspiration. I get rid of the mycosis by means of various local anti-mycotic preparations. At that time I was just suffering from one of the recurring mycoses, which is why I decided to try this bio-preparation. All went without complications and with superb effect.
However, the preparation does not list the information about its ingredients, which is also the case with other cosmetic products. My professional expertise enabled me to contact the manufacturer and ask him for more detailed information. The helpful attitude on the part of the company and the author of the recipe make it possible for me to share the acquired information with you as well. The advertised preparation consists of an original composition of microorganisms, dominated by a micromycet belonging to the Chromista-Stramenopila family, which has myco-parasitic impact on other microscopic fungi, such as Trichophyton rubrum, Scopulariopsis brevicaulis, Candida albicans etc. and feeds the nutritious substrate of these fungi by penetrating into their fibres and cells with its parasitic hyphas and drains nitrogen, carbon and also the sterols needed for its own reproduction process. This is the mechanism by means of which the "vampire" fungus exhausts the dermatoparasitic fungus. The parasitic fungus subsequently ceases to spread in the skin and the first symptom of the skin disease that is eliminated is the unpleasant itching. By weakening the parasitic fungus the preparation enables the organism to activate its own immunity mechanisms and the spontaneous exfoliation of keratin from the skin gradually removes the last remaining bits of mycotic infection. In the meantime, the other ingredients of the preparation help "desiccate" the interdigital spaces by suppressing their perspiration. The ingredients of the bio-preparation thus gradually dislodge the pathogenic mycoflora from the interdigital spaces by competing for their food and space. When the "vampire" has used up all the available nutrition, it disappears from the locality and makes it possible for a new physiological microflora to take over.
Practical experience with the application of the bio-preparation
Thanks to the fact that the cosmetic bio-preparation has already been in our market for a considerable time and also thanks to the fact that laboratory diagnostics of human mycoses is my professional field, I managed to get the recorded outputs of the survey in which the manufacturer was trying to establish the effectiveness of the bio-preparation in the cases of the patients who had agreed to be treated with the Biodeur preparation. All of the monitored respondents had been suffering from mycosis of feet /confirmed by laboratory tests/ and the bio-preparation was tested under a professional scrutiny of several Czech dermatologists. The resulting data provided the basis for this article.
The monitored patients /n = 69/ applied the bio-preparation to the affected parts of their feet, according to the instructions in the enclosed leaflet. The recommended application of the preparation was either a feet bath or a poultice. The baths of feet in a suspension of the preparation should be taken for 30 minutes for two subsequent days /approx. 24 hours apart/, and this pattern should be repeated after 7 days and than again after seven days. If the treatment is aimed at curing nail infection, then this procedure was combined with an overnight poultice applied in regular intervals. A thicker kind of suspension is to be used for the poultice.
The age of the monitored patients is stated in Figure 1, the youngest patient was 19 and the oldest 77 years old. They suffered from symptoms and diagnoses such as hidrotic syndrome,
Figure 1. The list of monitored patients treated with "Biodeur"
|
Age category /years/ |
Number of treated patients |
|
< 30 (* |
4 |
|
31 - 40 |
14 |
|
41 - 50 |
11 |
|
51 - 60 |
14 |
|
61 - 70 |
19 |
|
> 71 (** |
7 |
Legend: (* ..................... the youngest patient = 19 years old
(** ..................... the oldest person = 77 years old
/n = 43/, odorous symptoms /n = 42/, tinea pedis or tinea interdigitalis /n = 57/, or onychomycosis /n = 59/. These disorders were very frequently combined. All 69 monitored people were subjected to a laboratory examination aimed at finding microscopic fungi in the affected areas, and a positive result of this examination /i.e. the occurrence of the fungi/ was the basic precondition for listing then person as a patient for monitoring the effects of the bio-preparation. The following Figure 2 indicates that the mycosis could be diagnosed only in
Figure 2 Laboratory findings in cases of patients treated with Biodeur
|
Type of mycological finding - identified agens |
No. of findings |
% of positive cultivation /n = 30/ |
|
|
n = 69 |
% |
||
|
Only in microscopic quantities |
39 |
56.5 |
----------- |
|
Trichophyton rubrum |
12 |
17.4 |
40.0 |
|
Trichophyton mentagrophytes |
6 |
8.7 |
20.0 |
|
Trichophyton spec. |
1 |
1.4 |
3.3 |
|
Microsporum gypseum |
2 |
2.9 |
6.7 |
|
Candida albicans |
1 |
1.4 |
3.3 |
|
Candida parapsilosis |
2 |
2.9 |
6.7 |
|
Candida spec. |
1 |
1.4 |
3.3 |
|
Saccharomyces cerevisiae |
1 |
1.4 |
3.3 |
|
Scopulariopsis brevicaulis |
2 |
2.9 |
6.7 |
|
Fibrilar fungi /non-dermatophyta/ |
2 |
2.9 |
6.7 |
microscopic quantities in the cases of more than 50% of the patients, which does not correspond with some data listed in the related literature /5/ and neither with our own laboratory experience. In the cases of positive cultivations the most frequent findings were dermatophytes /n=21/, which means that these fungi were caught in 30.4 of the monitored patients. Trichophyton rubrum was found to be the dominant dermatophyte /n = 12/, which accounted for 40% of all positive cultivations.
The effect of bio-preparation was assessed one month after the last application. The subjective evaluation of the effect of the applications, made by the respondents of the survey,
Figure 3. The final effect of applying the bio-preparation
/assessed 1 month after the last application/
|
Type of disease |
No. of monitored patients |
Condition 1 month after 3 applications |
|||||
|
Disease was eliminated |
Condition improved |
Condition did not improve |
|||||
|
n |
% |
n |
% |
n |
% |
||
|
Odorous symptoms |
42 |
33 |
78,6 |
8 |
19,0 |
1 |
2,4 |
|
Hidrotic symptom |
43 |
29 |
67,4 |
12 |
27,9 |
2 |
4,7 |
|
Dermatomycosis |
58 |
48 |
82,8 |
10 |
17,2 |
0 |
0 |
|
Onychomycosis |
59 |
(** |
- |
43 |
72,9 |
16 |
27,1 |
Legend:
(* ..................... tinea pedis, tinea interdigitalis
(** ..................... it is impossible to come to any objective conclusion, because the time interval between the beginning of the therapy and the evaluation was too short
as well as the objective assessment of the attending doctors, indicated /Figure 3/ that the basic application of the preparation reduced the odorous symptoms in 76.6 % cases and significantly improved the condition in 19% of the cases. The hidrotic syndrome was indicated in 67.4 and 27.9 % of the monitored people. The degree of elimination the microscopic fungi demonstrated by mycosis was evaluated primarily with regard to the clinical data collected by the attending doctors, because complete sets of check-up laboratory examinations were not available. However, the clinical findings enable us to come to the conclusion that the preparation succeeded in improving the overall condition of all the patients suffering from tinea pedis and tinea interdigitalis, and managed to stop the eradicate the disease altogether in 82.8% of the patients. The only area which is difficult to evaluate for such a short period of time, is the impact of the preparation on the onychomycosis disease. 72.9 of the treated people showed some improvement. The success of the cure was measured according to the reduction of the hyper-keratitic substances under the nail disk, and partly also according to the growth of the new and healthy nail, change in colour of the affected nail disk and, last but not least, according to the relief of painful symptoms of onychomycosis.
Discussion
The issue of potential use of the bio-preparation has so far been evaluated mainly by experts on plant protection /6/. However, it has recently been used more and more frequently in standard medical science as well. Therefore, if we managed to make use of the antagonistic relationships and "killer" phenomena of some of the microscopic fungi, which can be used against micromycets that are noxious to human health or make life uncomfortable, it would be a major breakthrough in this area. These bio-preparations have large potential for application, especially in the cases of dermatomycotic diseases, and could help namely old people and patients affected by other elementary diseases which cannot be treated with standard antimycotics, for visceral reasons. The potential group of patients also includes people who develop allergic response or eczema when treated by topical chemotherapy.
There is no doubt about the fact that there would be a wide range of potential use of this bio-preparation. An extensive study /7/, which has recently been carried out in 29 European states and covered more than 100,000 patients, indicates that mycotic foot diseases are mostly related to:
a) male population
b) age group between 75 - 80 yrs
c) vascular diseases
d) foot-traumatising sports
e) diabetes mellitus /DM/ and
f) obesity
The occurrences of mycotic infections were clinically confirmed in individual countries.
The surprising phenomenon in the Czech Republic /CR/ was a high percentage of population that suffered from the related diseases; onychomycosis was clinically diagnosed in more than 40% of the sample and over 60% of people suffered from tinea pedis. The clinically diagnosed occurrence of mycotic disease was confirmed by mycological examination /cultivation assessment/ for study purposes. This research showed incidence of foot dermatomycoses at 2.5 - 8% and its prevalence at 41.3% of the Czech population. Mycotic diseases of fingernails are also quite frequent, even though they often originate as a "by-product", e.g. when both chiropodist and manicurist tools are used for treating mycotic toenails.
Onychomycosis is not a life-threatening disease, but it can be by no means waved away as a cosmetic problem. It is a potential chronic disease which needs at least the same attention as all other skin ailments. This disease is generally a long-term problem for the patients, is characterised by a considerable number of recurrences, can be very painful and may even result in severe psychic traumas and considerably reductions of life quality. In many cases it diminishes manual dexterity and mobility, makes it difficult if not impossible to do certain types of jobs /nurse, typist or operator, ballet dancer/, hinders people from doing certain types of recreational activities /playing keyboard or string musical instruments, sports such as football etc./, restricts social contacts, undermines one's self-confidence, and in addition to these there is the danger that the infection will spread to the adjacent fingers or to the family members, including children or grandchildren.
The foot and hand ailments are caused primarily by dermatophytosis /8, 9/. This finding has also been confirmed by our research. Our findings also correspond with the established fact that the second most frequent causative agents of the disease are fungi. Lately there has also been a growing number of non-dermatophytic nail infections caused by fibrillar microscopic mycetes, which also entails other kinds other than Scopulariopsis brevicaulis. The methods of picking up these causative agents have already been described many times /10, 11, 12, 13, 14/, but dealt mostly with sporadic isolations. However, these days they occur quite frequently, which may be related both to the prolonged productive life expectancy /there occurrence of onychomycoses grows with growing age/, and to a growing number of people with reduced immunity /patients who use immunodepresive medication, corticosteroids or chemotherapeutical substances/ and with other diseases /diabetes etc./, because the fungi of the types Aspergillus, Fusarium, Alternaria etc. belong to the group of so called opportune organisms that can cause secondary mycoses to people with altered physical condition. The pick-ups pf these fungi accounted for 13.4% of all cultivation positive cases we picked up in the monitored group, which is not a negligible percentage.
Conclusion
Skin mycoses and adnexas represent a significant medical and sociological problem both in terms of its treatment and its epidemiological, psychosocial and somatic impact, and their relevance increases with the growing incidence in national as well as global scale. This condition is also reflected by the growing number of people who are prone to such mycotic diseases /diabetics, people suffering from immunosuppression etc./
Onychomycosis may also imitate a number of other nail diseases, and vice versa. These ailments are consequently extremely difficult to diagnose, which is why they should be examined by professional dermatologists, in order to choose the most suitable therapy.
However, it is a pleasant fact that we have managed to find a natural and ecological method which effectively eliminates these microscopic substances and hampers their parasitic invasion of the skin and their adnexes. It is necessary to bear in mind that it is a cosmetic preparation, whose proper usage requires a certain amount of patience on the part of the user, who should also stick to the user's guide when applying the preparation. In spite of this fact we may safely confirm that it is a very effective and biologically clean preparation.
Bibliography
- 1. Mencl K.: The occurrence of dermatophytoses of feet at the military service. Vojenské Zdravotní Listy no.51, 1982, 256-260.
- 2. Mencl K.: Microscopic skin fungi at the military service. Týl Zásob 32, 1982, 45 - 47.
- 3. Kock B-W: Temperaturresistenz pathogener Dermatophyten und von Candida albicans unter Saunahnlichen Bedingungen. Mykosen 24, 1981, 33-37
- 4. Lison E, Clayton Y, Hay RJ, Hope Y, Midgley G.Moore M, Noble WC: The microbiology of foot infection, Mykosen 29, 1986, 147-152.
- 5. Nielsen PG: A Comparison between Direct Microscopy an Culture in Dermatologicka Mycotic Material. Mykosen 24, 1981, 555-560.
- 6. Veselý D: Studies of the mycoparasitism in rhizosphere of emerging sugar-beet. Zentralblatt Bakteriol II. Alt 133, 1978, 193-200.
- 7. Sladká J: The present results of the European-wide study Achilles and the interdisciplinary discussions about the prescription of systemic anti-mycotic substances in the Czech Republic. Medicína 7. 2000, 11.
- 8. Dvořák J, Weigl E: Aetiology of onychomycoses and tinea unguium. Acta Univ Palacki Olomuc. Fac Med 122, 1989, 39-44.
- 9. Williams HC: The epidemiology of onychomycosis in Britain. Br J Dermatol 31, 1994, /Suppl/. S68-S74
- 10. Barde AK, Singh SM: A case of onychomycosis caused by Curvularia lunata /Wakker/ Boedijn. Mykosen 26, 1983, 311-316
- 11. Ernst T-M: Nagel-Alternariose. Mykosen 26. 1983. 553-556.
- 12. Greet DL: Evolving role of non-dermatophytes in onychomycosis. Int J Dermatol 34, 1995, 521-524.
- 13. Onsberg P, Stahl D, Veien NK: Onychomycosis caused by Aspergillus terreus. Sabouradia 16, 1978, 39-46.
- 14. Singh SM, Barde Ak: Opportunistic infections of skin and nails by non-dermatophytic fungi. Mykosen 29, 1986, 272-277.
Contact Address:
MUDr. Karel Mencl, CSc.
Laboratory of Medical Mycology
Dept. of Microbiology
Pardubice Hospital