Dermatophytes:
Identifying prevention techniques and
treatments for fungal skin infections
Aaron Mills
Bio 594-Mycology
November 25, 2013
6:30 p.m.
Agenda
• Why we should be concerned
• Simple prevention techniques
• Advanced prevention techniques
• Treatments
• Potential for future research
Why should we care?
•Out of sight out of mind….Right?
•Can be debilitating
•Widespread globally and economically significant
•Treatments are expensive!
Prevention the Simple way
•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
The types of socks worn is
important
More Simple Prevention
•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
Advanced Prevention Methods
Heavy Metals
•Can be used at low concentrations (makes them safe)
•Inactivate intercellular proteins
• Silver is primary metal
•Also use copper, zinc, and cobalt
The Silver Ion Laundry Machine
•Lowered fungal loads by 4 log10 CFU ml-1 with and
without detergent
•Spin cycle important step
With Detergent
Without Detergent
Jung et. al 2007
Copper Lined Socks
•Used to reduce fungal loads in patients
•Potential preventative use
•Moisture activated
Gargiulo et al. 2012
Antimicrobial Clothing
•Two types of agents
•-static
•–cidal
•Antimicrobial clothing is a biocide
•QAC- Quanternary ammonium compounds
•PHMB- Polyhexamethylene Biguanides
QAC
PHMB
Antimicrobial Clothing
•Effectiveness
•Clothing that these
compounds are added to
include: sportswear, socks,
shoe liners, and lingerie
•Concerns with
antimicrobial fabric
Hammer et al. 2012
Ozone Gas
Two Treatment types:
•Passive treatment
•Effectiveness issues
•Direct treatment with drying heat
•Most effective treatment
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
The Future
•Need to increase public awareness and sense of
importance
•Research to improve and refine preventative measures
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, 344351. 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
of Dermatology, 39, 25-27. Retrieved from EBSCOhost Academic Search Complete database.
• Jung, W.K, Kim, S.H, Koo, H.C., Shin, S., Kim, J.M., Park, Y.K., …, & Park, Y.H. (2007). Antifungal activity of the silver ion against
contaminated fabric. Mycoses, 50, 265-269. doi: 10.1111/j.1439-0507.2007.01372.x
•Masri-Findling, G.D. (1996). Dermatophytosis of the feet. Cutaneous Mycology, 14(1),33- 40. Retrieved from EBSCOhost
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