HERBS FOR COMBATTING DERMATOPHYTOSIS- A REVIEW
HTML Full TextHERBS FOR COMBATTING DERMATOPHYTOSIS-A REVIEW
R. Meena * 1 and R. S. Ramaswamy 2
Department of Sirappu Maruthuvam 1, National Institute of Siddha, Chennai - 600047, Tamil Nadu, India.
Director General, Central Council for Research in Siddha 2, Arumbakkam, Chennai - 600106, Tamil Nadu, India.
ABSTRACT: Infinite varieties of plants- both medicinal and aromatic are seen on the Indian continent. Siddha system of medicine is effectively making use of them. Sage Yugi have classified skin diseases into 18 kuttas. Pundareega kuttam is one among them. It can be correlated to dermatophytosis in modern science. Siddhars, scientists of a sort have found a remedy to the newly emerging mysterious diseases during their lifetime in the remote past. A thorough literature survey brings them to the limelight. Medicinal plants with antimicrobial activity are found widely in Siddha literature. Many effective compound formulations are also available to treat dermatophytosis. This article focuses on the herbs having in-vitro anti- dermatophytic activity and medicinal plants in Siddha literature for treating dermatophytosis. This preliminary literature search will help to understand the potential for further research in this area.
Keywords: |
Pundareega kuttam, Dermatophytosis, Siddha medicine, In-vitro anti-dermatophytic activity
INTRODUCTION: Fungal skin infections can be classified into superficial mycosis and deep mycosis. In superficial mycosis, the infection is restricted to stratum corneum while deeper layers are infected in deep mycosis. Mainly immune compromised patients are victims of deep mycosis. Dermatophytosis also called as tinea or ringworm is an infection caused by a group of keratinophilic fungi called dermatophytes. The three major genera causing tinea are Trichophyton, Microsporum and Epidermophyton 1, 2. Dermatophytes colonize the skin, nails, and hair of the human population. It affects the keratinous tissues of humans and other vertebrates and thus causes superficial infections 3.
Utilization of the plants as antimicrobials in the cure of infectious diseases is not a new concept. It is in vogue from the ancient times. Herbal medicines have minimal side effects when compared to synthetic drugs. The alarming increase in dermatophyte infection, drug resistance, frequent remissions and relapses and the hepatotoxicity caused by some oral synthetic antifungal agents are the matter of deep concern.
In Siddha system of medicine, the term kuttam denotes various skin diseases. Sage yugi has classified kuttam into 18 types, and padarthamarai kuttam (Pundareega kuttam) is one among them. This padarthamarai kuttam can be correlated to dermatophytosis in modern science. It is a variety in which the patches are pale red in the center and dark red on the edges resembling the petals of the lotus. Padarthamarai kuttam can be correlated to dermatophytoses. This article is focussed on herbal remedies for tinea infection. The herbs mentioned in Siddha literature for Padarthamarai, Padai, etc., the results of herbs whose in-vitro anti-dermatophytic activity was scientifically validated is also mentioned.
Literature Survey: 4 The below-mentioned herbs in Table 1 are potent antimicrobial and antifungal agents as per Siddha literature.
TABLE 1: HERBS FOR FUNGAL INFECTIONS
Botanical name | Vernacular name | Part used |
Azadirachta indica | Neem tree, margosa tree | Leaf, unripe fruit, oil, bark |
Allium sativum | Garlic | Bulb |
Indigofera tinctoria | Indian indigo plant | Leaf, root |
Alangium salvifolium | Sage left alangioma | Bark, seeds |
Cynodon dactylon | Bermuda grass, bhama grass | Root, grass |
Corallocarpus epigaeus | Bryons | Root, tuber |
Aristolochia bracteolata | Worm killer, Indian birthwort | Whole plant |
Cassia alata | Ring worm shrub | Leaf, root, flower |
Curcuma longa | Turmeric | Rhizome |
Ferula asafoetida | Asafoetida | Gum |
Thespesia populnea | The portla tree ( heartwood) | All parts |
Calophyllum inophyllum | Alexandria laurel | Flower, leaf, oil, seed, bark |
Tamarindus indica | Tamarind tree | Leaf |
Pongamia pinnata | Indian beech | Seed, oil, root, flower |
Sterculia foetida | Poon tree, pinery | Seed, bark |
Aquilaria agallocha | Aloe wood, eaglewood | Wood, resin |
Nerium odorum | The oleander | Root bark, flower |
Smilax china | China root | Root tuber |
Butea monosperma | Flame of the forest | Seed |
Artocarpus heterophyllus | Jack fruit tree | Leaf |
Momordica charantia | Bitter gourd | Fruit, leaf |
Lawsonia inermis | Henna plant | Leaf |
Pistia stratiotes | The water lettuce | Leaf |
Mirabilis jalapa | Four o ‘clock flower | Leaf |
Lepidium sativum | Garden cress | Seeds |
Clerodendum inerme | Smooth volkameria | Leaf |
Euphorbia ligularia | Common milk hedge | Leaf |
Datura mete | Datura ( white flowering) , thorn apple | Leaf |
Strychnos nux vomica | Strychnine tree | Fruit, seed |
Calotropis gigantea | Gigantic swallow-wort | Root. bark |
Jatropha curcas | Purging nut | Oil |
Sesamum indicum | Gingely oil | Seed oil |
Alstonia scholaris | Devil tree, shaitan wood | Root |
Carum copticum | The bishop weed | Seed |
Terminalia chebula | Chebulic myrobalan | Fruit |
Curcuma aromatica | Cochin turmeric | Rhizome |
Mallotus philippinensis | Monkeyface tree | Powder on fruit |
Spaeranthus indicus | East Indian globe thistle | Leaf |
Eclipta prostata | Trailing eclipta | Whole plant |
Gloriosa superba | Superb lily, Malabar glory lily | Rhizome |
Euphorbia aniquoram | Quadrangular spurge | Milk |
Jatropha curcas | English physic nut | Leaf, seed |
Madhuca indica | Butter trees | Bark, seed |
Cassia absus | Horse gram ( black) | Leaf, seed |
Albizzia lebbeck | Sirissa tree | Flower |
Psoralea corylifolia | Bakuchi seeds | Seeds |
Crotalaria retusa | Rattle wort | Leaf |
Portulaca oleracea | Common indian parselane | Leaf, seed |
Oxalis corniculata | The Indian sorrel | Leaf |
Phyllanthus amarus | Indian Phyllanthus | Whole plant |
Holarrhena pubescens | The kurchi | Bark, seed |
Majorana hortensis | Southernwood | Whole plant |
Pterocarpus marsupium | The Indian kino tree | Leaf |
Allium cepa | Onion | Bulb |
Prunus dulcis | Almond | Nut |
Centella asiatica | Indian pennywort | Whole plant |
Paspalum scrobiculatum | Kode millet | Straw, rice |
Bambusa arundinaceae | Bamboo | Root |
Boerhavifusa diffusa | Hogweed, pigweed | Root |
Moringa oleifera | Drum stick tree | Bark |
Piper nigrum | Black pepper | Seed |
Ammania baccifera | Blistering ammania | Leaf |
Desmotachya bipinnata | Salt reed- grass | leaves |
Clerodendrum phlomoidis | Wind killer | Leaf |
Piper longum | Long pepper | Unripe fruit |
Cocos nucifera | Coconut tree | Oil from fruit |
Heliotropium Indicum | Heliotrope, Indian turnsole | Leaf, flower |
Cordia dichotoma | Fragrant manjack | Bark, fruit |
Gossypium arboreum | Tree cotton | Seeds, root, bark |
Argemone mexicana | Mexican poppy | Seeds, seed oil |
Boswellia serrata | Salai | Gum resin |
Acalypha indica | Indian nettle | Leaf |
Plumbago zeylanica | Ceylon leadwort or doctor bush | Root, bark |
Cassia fistula | Golden shower tree | Bark |
Rungia repens | Creeping rungia | Leaves |
Cyperus rotundus | Nutgrass | Root tuber |
Coccinia grandis | Ivy gourd | Leaf |
Trianthema decandra | Spreading hogweeds | Leaf, root |
Santalum album | Sandalwood | Oil, wood |
Indigofera aspalanthides | Black henna, commercial indigo | Leaf, flower, root |
Tinospora cordifolia | Guduchi | Stems, root, leaf |
Nigella sativa | Black cumin | Seeds |
Vernonia anthelmintic | Wormseed | Seeds |
Semecarpus anacardium | Marking nut tree | Fruit |
Cassia tora | Fetid cassia | Seed, leaf, root |
Acorus calamus | Sweet flag | Rhizome |
Cassia senna | Country senna, tinnellvelly senna | Leaf |
Herbs with Scientific Validation: Nowadays, study on dermatophyte infections has assumed greater importance because of the significant increase in statistics of patients with HIV AIDS, diabetes mellitus, cancer and organ transplantation 5. In this context, Computerised literature search was done. Search was through google search engine, Pub Med, Willey online library, and Cochrane library till date. Primary search terminologies used were in-vitro antidermatophytic activity, herbs or medicinal plants. Search was preceded further by mentioning the botanical names of the plants in Siddha literature.
The herbs so far tested for their action against dermatophytes and their results are discussed below. The aqueous extracts of Pergularia tomentosa and Mitracarpus scaber at the concentration of 10, 20, 40, 80 and 160 mg/ml were active on trichophytom mentagrophytes and trichophyton rubrum. These plants showed activity against microsporum audouini and microsporum gypseum only at the concentration of 80mg/ml and 160 mg/ml. The chloroform and hexane extract of Pergularia tomentosa showed activity against T. rubrum, T. mentagrophytes, M. gypseum at low concentration of 10 mg/ml. A negative result is also reported by the author. The aqueous extract of Stereospermum kunthianum and Euphorbia balsamifera at the concentration of 10, 20, 40, 80,160 mg/ml is not effective against any of the dermatophytes tested.
Further, studies can be carried out at higher concentrations 6. Hee Youn Chee had conducted a study to investigate the antidermatophytic activity of clove essential oil and its volatile vapour. The study result showed that the volatile vapour of clove essential oil was strongly active to T. rubrum and T. mentagrophytes. The spore germination of the above two organisms were completely inhibited by the volatile vapour of clove essential oil. It also strongly inhibits the mycelial growth of Epidermophyton floccossum and Microsporum audiouinii. The MIC of clove oil was 1% for T. rubrum and T. mentagrophytes, 5% and 2.5% (in brith assay) for E. floccose and M. audiouinii. It is inferred from the study that clove oil possesses fungicidal activity and its vapour has fungistatic activity 7. A research study reveals that water and etanolic extracts of leaves of Azadirachta indica, Jatropha curcas, Jatropha gossypifolia, Cassia alata, Aloe vera, and Anacardium occidentale were assessed in-vitro for their efficacy in treating ringworm infections. At the concentration of 2mg/l, 5 mg/l the aqueous extract of aloe vera was found to be effective against T. mentagrophytes and T. rubrum.
Cassia alata at the concentration of 5 mgl-1 was active against T. mentagrophytes and at 2 mgl-1 active against T. rubrum. Jatropha gossypifolia’s aqueous extract was effective against T. rubrum at 2 mgl-1 itself. The ethanolic extract of leaves of Aloe vera, Anacardium occidentale, Azadirachta indica, Jatropha curcas, Jatropha gossypifolia showed very high activity against T. mentagrophytes and T. rubrum at the concentration of 2, 5, 10 mgl-1. This is evident from the above that ethanol can extract the phytochemicals effectively 8.
Nadkarni in the year 1956 itself has mentioned the use of Neem and Pongamia pinnata in the treatment for ringworm. T. mentagrophytes was found to be susceptible to Ocimum sanctum leaves, Cassia tora leaves, Cassia occidentalis, resins of Shorea robusta, seeds of Mucuna pruriens, the fruit of Ficus oppositifolia and stem of Curcuma longa. 10mg/ml is found to be the MIC of ether extract of resins of Shorea robusta and the same for chloroform extract of Moringa pterigosperma and stem of Curcuma longa 9. Limonene pepeljnak et al., 2005; sonboli et al., 2006, a naturally occurring monoterpene detected in the essential oils of several plants is a very good fungicidal agent. It is active against T. rubrum at a concentration of 0.5% v/v 10.
In a research work carried on with the leaf extracts and stem barks of Xylosma longifolium, it is found that the herb exhibited moderate, moderate antidermatophytic activity against M. canis M. gypseum by petroleum ether extract. The chloroform and methanol extract also showed activity against, and T. ajelloi 11 Inouyes et al., has carried out a screening assay of 72 essential oils against T. mentagrophtes. The most active essential oils were Origanum vulgare, Thymus serpyllum, Eugenia caryophyllum, Cymbopogon nardus, Pelargonium roseum, Lindera umbellata, Aniba rosaeodora, Thymus vulgaris, Lavandula latifolia, L. angustifolia, Maleleuca alternifolia 12, 13. In a study on cinnamomum oil the author correlated the antifungal activity with its chemical constituents. The toxicity against dermatophytes are due to the high level of cinnamaldehyde (44.2%) eugenol (90.2%) present in Cinnamomum zeylanicum. The increased amount of benzyl benzoate? (>50%) in leaf oil of C. rhynchophyllum, C. microphyllum, C. pubescens, C. impressicostatum & C. mollissimum is responsible for selective toxicity against dermatophytes 14.
An in-vitro and in-vivo study was carried out to find the antidermatophytic activity of Polyscias fulva. The crude extract of stem bark powder of the plant and hexane, ethyl acetate fraction, n-butanol fraction and residue fractions were tested against 8 dermatophyte species. Except for hexane fraction, the others exhibited more than 20 mm zone of inhibition. The MIC of crude extract was 0.5-1. The study that the extract oil formulation at 5% mats is useful in treating tinea infections 15. In a study on Azadirachta indica, it was observed that the neem seed extract was most effective against all organisms tested with MIC and MFC of 31.25 µg/ml. Ethyl acetate extract of neem leaf was effective against T. violaceum and E. floccossum. Ethanolic extracts showed activity against T. rubrum and M. nanum with 250µg/ml as MIC 16. Venugopal and Venugopal in 1994 worked on 88 clinical isolates of dermatophytes. He tried out the antidermatitic activity with ethanolic and aqueous extracts of neem leaves.
10 mg/ml ethanolic extract of Achyanthes aspera showed 23 mm zone of inhibition and 19 mm in aqueous extract against T. rubrum 17. There is a mention in most of the Siddha literature that Ocimum sanctum is excellent for respiratory ailments. But the herb’s antidermatophytic activity was scientifically validated by Balakumar S et al., in 1995. Aqueous, alcoholic, hexane, benzene, chloroform, ethyl acetate, methanol fraction and water fraction of Ocimum sanctum were tested against T. mentagrophytes, T. rubrum, M. gypseum, M. nanum, E. floccossum. The alcoholic extract showed best activity. All the extracts of Ocimum sanctum inhibited T. mentagrophytes growth at lower concentrations (125.00 ± 25.00 µg/ml to 206.66 ± 101.03 µg/ml) 18. Ethanolic extract of Ixora brachiata leaf and root completely inhibited the growth of dermatophytes with MIC 5 µgml-1 for leaf and 2.5 µgml-1. The root and leaf are rich in starch, tannin, saponin, protein, anthraquinone, reducing sugar and glycosides 19.
Dynaria quercifolia (L) J. Smith is an epiphytic fern. Coumarins present in the ethyl acetate extract of D. quercifolia may be responsible for its activity against T. mentagrophytes says Batool Sadeghi Nejad. Its zone of inhibition is the 25mm distance at the concentration of 20 mgml-1. Tripathy and Dixit in 1978 have reported that Lawsonia inermis exhibit strong toxicity where the naphthoquinones are the active factor. The chloroform extract of the plant showed activity against T. rubrum, T. equinum, M. canis, and M. gypseum and the zone of inhibition was above 20 mm 20. Ar- turmerone, a major compound in turmeric oil has effective antidermatophytic activity against T, rubrum, T. mentagrophytes, E. floccossum and M. gypseum with MIC of 3.90 to 7.81 µg/ml 21. The water extract, methanol, free flavonoid and bound flavonoids of three medicinal plants namely Allium sativum, Cymbopogon martinii and leaves of Catharanthus roseus showed activity against T. rubrum, T. mentagrophytes, and M. gypseum 22.
In a study on ringworm in animals, it has been concluded that Aloe vera and garlic can be used for treating ringworm infection 23. The oil of Curcuma domestiga has fungicidal property and also inhibits heavy doses of inocula 24. The activity of some Mexican plants against the dermatophytes T. rubrum and T. mentagrophytes is tested. Hexane and methanol, extract of Annone cherimolia, Asclepa curassavica, Bixa orellana, Eupatorium aschenbornianum, Galphimia glauca, Lysiloma acapulcensis, Malva parviflora, Sedum oxypetalum, Senecio angulifolius showed activity against T. rubrum and T. mentagrophytes 25. The efficacy of Trachyspermum ammi was found to be more effective than the standard used. Based on the results of a clinical trial, it is also reported that it does not cause any skin irritation 26.
Based on the in vitro results of Malaleuca alternifolia (tea tree oil), four randomized controlled trial on patients with Tinea pedis was conducted. Eternal application of Tea tree oil is effective in Tinea pedis and onychomycosis condition says reports of the clinical trial 27, 28, 29, 30, 31. The MIC of tea tree oil for T. rubrum is 1.0% v/v and for T. mentagrophytes is 0.3-0.4% v/v. Moreover, at higher concentrations tea tree oil act as fungicidal agent. It is believed that the major constituent responsible for this antifungal activity is terpene 4-ol 32.
Reports are available on the untoward effects of tea tree oil. It has been reported to cause allergic contact dermatitis in a few cases 33, 34, 35. Like aqueous neem extract of Allium, sativum also was tested against 88 clinical isolates of dermato-phytes. 1:150 and 1:100 dilutions of aqueous extract of garlic inhibited 50% and 90% of the isolates respectively 36. Allicin, a bioactive compound from garlic showed MIC ranging from 0.78 to 12.5 µg/ml against T. rubrum 37. Clinical trials were carried out on the effectiveness of ajoene, derived from garlic in Tinea cruris and Tinea corporis 38, 39. Seaweeds, a source of bioactive compounds are found to have action against dermatophytes at a concentration of 50 and 100 µl of chloroform, ethanol, methanol and aqueous extract. The zone of inhibition was around 5 mm to 10 mm only 40.
M. S. Ali-shtayeh reported that at a concentration of 15 µgml-1, Capparis spinosa and Juglans regia completely inhibited the growth of M. canis and T. violaceum. He also had carried out his work on 20 more plant extracts 41. Crude ethanolic extract of Senna alata Linn has MIC of 5.0 mgml-1 against dermatophytes. A similar study was also carried out in Malaysia by Ibrahim and Osman 1995 42. A double-blind clinical trial was conducted with the leaf extracts of Solanum chrysotrichum 42, 43.
10% Piper beetle cream with 80µg of piper betle leaf extract was found to be effective against M. canis, M. gypseum, T. mentagrophytes 44. Indurubin is an active compound isolated from Wrightea tinctoria R.Br. The chloroform extract of the leaf was effective against T. rubrum and E. floccossum at the concentration of 0.5 mg/ml. The MIC for E. floccossum is 6.25 µg/ml and for T. rubrum, T. tonsurans it is 25 µg/ml. MIC for T. mentagrophytes and T. simii is 50 µg/ml.
CONCLUSION: Many antifungal agents are beyond the search of common man due to prohibitive cost so; people turn back to traditional means of treatment. The practitioners of the Siddha system of medicine have therefore to convince themselves of the safety and soundness of their medicines. It is hoped that this literature survey will help to understand that there are a large number of herbs awaiting further research regarding their anti-dermatophytic activity. Research in this area will go a long way in putting the Siddha system of medicine on scientific ground.
ACKNOWLEDGEMENT: Nil
CONFLICT OF INTEREST: Nil
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How to cite this article:
Meena R and Ramaswamy RS: Herbs for combatting dermatophytosis-A review. Int J Pharmacognosy 2014; 1(6): 373-379. doi link: http://dx.doi.org/10.13040/IJPSR.0975-8232.IJP.1(6).373-379.
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