ABSTRACT
The comparative study on the effect of the locally made black soap and Dudu osun soap on dermatophytes isolated from barbing equipment using agar well diffusion method. The fungi isolated from the barbing equipment are Trichophyton rubrum (56.25%), Microsporum canis (28.13%), and Trichophyton mentagrophytes (15.63%). The isolates were treated with Dudu Osun and Black soap, the result showed that Trichophyton rubrum was resistance to 100% concentration of dudu soap but has a high growth level for 200, 300, and 400 concentration. In its treatment with black soap it was sensitive to all concentration. Trichophyton mentagrophytes was sensitive to 100% and 400% concentration but has a high growth at 200% and 300% concentration in the treatment of dudu soap. It showed sensitivity at 200 and 300 concentation and a high growth at 100 and 400 concentration for the treatment of black soap treatment. Microsporum canis was sensitive to dudu soap treatment at 100% and had a high growth at 200%, 300%, and 400% concentration. In its treatment with black soap. It showed sensitive results at 200% and 300% but a highly growth on 100% and 400%. All controls had maximum growth. The results obtained revealed that the traditional black soap exhibited a high level of antimicrobial activities resulting in greater zones of inhibition against dudu osun soap. Hence, African black soap through this study can thus, be recommended for use since it has potentials of treating hair and skin diseases.
CHAPTER ONE
LITERATURE REVIEW
1.1 INTRODUCTION
The term normal microbial flora or microbiota denotes the population of microorganism that inhibits the skin and mucous membranes of healthy normal persons. Research has shown that this normal flora now referred to as normal microbiota provide a first line of defense against microbial pathogens, assist in digestion, play a role in toxin-degradation, and contribute to maturation of the immune system. Shifts in the normal microbiota or stimulations of inflammation by these commensals may cause disease as inflammatory bowel disease (Tachibana, 1976). The density and composition of the normal flora of skin vary with anatomical location. The makeup of the normal flora depends, upon various factors including genetic, sex, age, stress, nutrition and diet of the individuals. Human skin is subject to degenerative changes due to daily exposure to environment and the impact of microorganisms. Several studies have been carried out to determine the normal flora of the skin. (Marhall et al., 1987)Presented a comprehensive review of the normal flora of the foot. He stated that the flora of the foot is similar to that found in the other skin site. (Marples, 1992 )Believe that some differences exist between foot flora and other skin site. Black soap has anti-aging properties and can reduce fine lines and wrinkles for youthful, smoothskin. Dark spots and blemishes are evened out and the natural ingredients effectively cleanse and deodorize. Black soap does not contain specific antimicrobial ingredient, many people prefer this soap because it does not cause resistant bacteria growth. Black soap is also a natural source of vitamins A, E and irons which helps to strengthen the skin and hair. Medicated soaps to a large extend remove dirts and disrupt cytoplasmic membrane to kill microorganisms (Hunt, 1999). It also works against enveloped virus like human immunodeficiency virus (HIV). Several anti-microbial substances are found in medicated soaps and they have various mode of action on various skin micro-flora. This study is aimed at identifying microorganisms commonly present on the human skin and also to compare the effectiveness of some medicated soaps and locally prepared black soaps on the isolates obtained from the skin.
Soaps and other cleansing agents have been around for quite long time. Archeological findings during the excavation of ancient Babylon revealed a soap-like material in clay cylinders. Inscriptions on the cylinders indicate that fats were boiled with ashes, which is a method of making soaps. Likewise, a medical document from about 1500 B.C. shows that Egyptians combined animal and vegetable oils with alkaline salts to form a soap-like material used for treating skin diseases, as well as for washing (Hunt, 1999). Moses, in the Bible, gave the Israelites detailed laws concerning personal cleanliness. He also related cleanliness to health and religious purification. People were instructed to wash their clothes and bath in water. Nowadays, disinfection, decontamination, antisepsis/sanitization, and sterilization just naming a few, there are terms that describe processes of cleaning by either using soaps/detergents or other cleaning agents (Hunt, 1999). Numerous cleaning agents are available in the market, which are presented in various forms with distinct formulations. Triclosan, trichlorocarbamide and p-chloro-m-xylenol (PCMX/chloroxylenol) are the commonly used antibacterials in medicated soaps. These are generally, only contained at preservative level unless the product is clearly marked as antibacterial, antiseptic, or germicidal (Lason, 1988).
Scrubbing body or hands, particularly with soaps, is the first line of defense against bacteria and other pathogens that can cause colds, the flu, skin infections and even deadly communicable diseases(Lason, 1988). Conceptually, many people consider that an antimicrobial potion of soaps is effective at preventing communicable diseases. But now researchers highlight that too much of it can have the opposite effect-spreading diseases/infections instead of preventing them. Overutilization of medicated soaps might result in antimicrobial resistance and even rendering an individual more vulnerable to microbial attacks such as opportunistic skin infections (White and McDermott, 2011).
1.2 AIM AND OBJECTIVES
The study is aimed at determining the antifungal activity of locally made soap on dermtophytes isolated from barbing equipment.
Objectives
The objectives are as stated;
- To isolate the dermatophytes from barbing equipment,
- To determine the effect of antifungal soaps on dermatophytes isolated
1.3 LITERATURE REVIEW
MYCOSIS
Mycosis (plural: mycoses) is a fungal infection of animals, including humans. Mycoses are common and a variety of environmental and physiological conditions can contribute to the development of fungal diseases. Inhalation of fungal spores or localized colonization of the skin may initiate persistent infections; therefore, mycoses often start in the lungs or on the skin (Hay, et al., 2010).
Classification
Mycoses are classified according to the tissue levels initially colonized.
Superficial mycoses
Superficial mycoses are limited to the outermost layers of the skin and hair (Malcolm, et al., 2012). An example of such a fungal infection is Tineaversicolor, a fungus infection that commonly affects the skin of young people, especially the chest, back, and upper arms and legs. Tineaversicolor is caused by a fungus that lives in the skin of some adults. It does not usually affect the face. This fungus produces spots that are either lighter than the skin or a reddish-brown. This fungus exists in two forms, one of them causing visible spots. Factors that can cause the fungus to become more visible include high humidity, as well as immune or hormone abnormalities. However, almost all people with this very common condition are healthy.
Cutaneous mycoses
Cutaneous mycoses extend deeper into the epidermis, and also include invasive hair and nail diseases. These diseases are restricted to the keratinized layers of the skin, hair, and nails. Unlike the superficial mycoses, host immune responses may be evoked resulting in pathologic changes expressed in the deeper layers of the skin. The organisms that cause these diseases are called dermatophytes. The resulting diseases are often called ringworm (even though there is no worm involved) or tinea. Cutaneous mycoses are caused by Microsporum, Trichophyton, and Epidermophyton fungi, which together comprise 41 species.One common disease is the athlete's foot which most commonly affects children before puberty. It is divided in three categories: chronic interdigital athlete's foot, chronic scaly athlete's foot, and acute vesicular athlete's foot (Hay, et al., 2010).
Subcutaneous mycoses
Subcutaneous mycoses involve the dermis, subcutaneous tissues, muscle and fascia. These infections are chronic and can be initiated by piercing trauma to the skin which allows the fungi to enter. These infections are difficult to treat and may require surgical interventions such as debridement.
Systemic mycoses due to primary pathogens
Systemic mycoses due to primary pathogens originate primarily in the lungs and may spread to many organ systems. Organisms that cause systemic mycoses are inherently virulent. In general primary pathogens that cause systemic mycoses are dimorphic.
Systemic mycoses due to opportunistic pathogens
Systemic mycoses due to opportunistic pathogens are infections of patients with immune deficiencies who would otherwise not be infected. Examples of immunocompromised conditions include AIDS, alteration of normal flora by antibiotics, immunosuppressive therapy, and metastatic cancer. Examples of opportunistic mycoses include Candidiasis, Cryptococcosis and Aspergillosis
1.3.1 DERMATOPHYTES
Dermatophytesare a common label for a group of three types of fungus that commonly causes skin disease in animals and humans. These anamorphic (asexual or imperfect fungi) genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota. Dermatophytes cause infections of the skin, hair and nails, obtaining nutrients from keratinized material (Midglay et al., 1994).The organisms colonize the keratin tissues causing inflammation as the host responds to metabolic by-products. Colonies of dematophytes are usually restricted to the non living cornified layer of the epidermis because of their inability to penetrate viable tissue of an immune-competent host. Invasion does elicit a host response ranging from mild to severe. Acid proteinases, elastase, keratinases, and other proteinases reportedly act as virulence factors. The development of cell-mediated immunity correlated with delayed hypersensitivity and an inflammatory response is associated with clinical cure, whereas the lack of or a defective cell-mediated immunity predisposes the host to chronic or recurrent dermatophyte infection.
Some of these skin infections are known as ringworm or tinea. Toenail and fingernail infections are referred to as onychomycosis. Dermatophytes usually do not invade living tissues, but colonize the outer layer of the skin. Occasionally the organisms do invade subcutaneous tissues, resulting in kerion development.
1.3.2 DERMATOPHYTOSIS
Dermatophytosis is a clinical condition caused by fungal infection of the skin in humans, pets such as cats, and domesticated animals such as sheep, goats and cattle. The most common term for the infection, “ringworm”, is a misnomer, since the condition is caused by fungi of several different species and not by parasitic worms. The fungi that cause parasitic infection, collectively dermatophytes, feed on keratin, the material found in the outer layer of skin, hair, and nails. These fungi thrive on warm and moist skin, but may also survive directly on the outsides of hair shafts or in their interiors. In pets, the fungus responsible for the disease survives in skin and on the outer surface of hairs.
Currently, up to 20% of the population may be infected by dermatophytes at any given time (Mahmoud et al., 2009). It is especially common among people who play sports involving skin-to-skin contact, wrestling in particular. Wrestlers with ringworm may be withheld from competition until their skin condition is deemed noninfectious by the proper authorities (Decorby and MaryAnn, 2009).
1.4 CLASSIFICATION
A number of different species of fungi are involved in dermatophytosis. Dermatophytes of the genera Trichophyton and Microsporum are the most common causative agents. These fungi attack various parts of the body and lead to the conditions listed below. The Latin names are for the conditions (disease patterns), not the agents that cause them. The disease patterns below identify the type of fungus that causes them only in the cases listed:
- Dermatophytosis
- Tineapedis (athlete's foot) – fungal infection of the feet
- Tineaunguium – fungal infection of the fingernails and toenails, and the nail bed
- Tineacorporis – fungal infection of the arms, legs, and trunk
- Tineacruris (jock itch) – fungal infection of the groin area
- Tineamanuum – fungal infection of the hands and palm area
- Tineacapitis – fungal infection of the scalp and hair
- Tineabarbae – fungal infestation of facial hair
- Tineafaciei (face fungus) – fungal infection of the face
- Other superficial mycoses (not classic ringworm, since not caused by dermatophytes)
- Tineaversicolor – caused by Malassezia furfur
- Tineanigra – caused by Hortaeawerneckii
1.5TINEA BARBAE
Tineabarbae is a superficial dermatophyte infection that is limited to the bearded areas of the face and neck and occurs almost exclusively in older adolescent and adult males. The clinical presentation of tinea barbae includes inflammatory, deep, kerionlike plaques and non-inflammatory superficial patches resembling tineacorporis or bacterial folliculitis.
1.5.1 PATHOPHYSIOLOGY
Tinea barbae is caused by the keratinophilic fungi (dermatophytes) that are responsible for most superficial fungal skin infections. They infect the stratum corneum of the epidermis, hair, and nails. Several enzymes, including keratinases, are released by dermatophytes, which help them invade the epidermis. The mechanism that causes tinea barbae is similar to that of tinea capitis. In both diseases, hair and hair follicles are invaded by fungi, producing an inflammatory response. Tinea barbae is caused by both zoophilic and anthropophilic dermatophytes.
Infection caused by zoophilic dermatophytes usually is of greater severity than that produced by anthropophilic organisms. Thus, zoophilic dermatophytes are the primary cause of inflammatory kerionlike plaques, which most likely result from a more intense host reaction. Kerion formation has been described as resulting from Trichophytonrubrum infection (Beswick et al., 1999). T rubrum, an anthropophilicdermatophyte, can invade hair shafts and deeper tissues (although rarely), resulting in an inflammatory reaction. Usually, infection involving hair is more severe; therefore, tineabarbae caused by anthropophilic dermatophytes often has a more severe course than tineacorporis caused by the same pathogen. Dermatomycoses may be due to pets and farm animals, sometimes from unusual dermatophytes. Trichophytonerinacei, a zoophilic dermatophyte occasionally harbored by hedgehogs, was linked with kerion-type tineabarbae in a 37-year-old man with the infection apparently transferred to his partner by direct contact from kissing (Sidwell et al., 2014).Inflammatory tinea barbae was shown to be caused by Arthrodermabenhamiae in both a patient and his guinea pig (Braun et al., 2013).
The formation of kerion is postulated by 2 theories. The first theory suggests that it results from diffusion of metabolites and/or toxins from the fungus; however, kerion formation most likely results from an immunologic response to dermatophyte antigens.
1.5.2 EPIDEMIOLOGY
United States: Tinea barbae is uncommon in the United States.
International
Currently, tineabarbae is infrequent around the world. As with other dermatophytoses, tineabarbae is more common in countries in which weather is characterized by high temperatures and humidity. Tinea barbae was observed more frequently in the past before single-use razors became available, and infection frequently was transmitted by barbers who used unsanitary razors. Therefore, it is not surprising that tineabarbae once was termed barber's itch. Now that habits and equipment have changed, this source of infection has been all but eliminated. Currently, tinea barbae is more common among rural inhabitants, and zoophilic dermatophytes constitute its primary pathogens.
Sex
Men are affected almost exclusively by tinea barbae because the disease involves the bearded areas of the face and neck. Involvement of the same areas in healthy women and children is classified as tinea faciei.
Age
Hair appears on the face at puberty; therefore, tinea barbae may occur almost exclusively in older adolescent and adult males.
1.5.3 HISTORY
Infection often begins on the chin or neck, but in severely affected patients, tinea barbae may cover the entire bearded area of the face and neck, occasionally resulting in indurated verrucous plaques or nodules.
Tineabarbae may be asymptomatic; however, mild pruritus is characteristic. Spontaneous resolution of tinea barbae may occur, especially in inflammatory tineabarbae.
Lupoidsycosis, a deep form of tinea barbae, is so named because it may resemble lupus vulgaris(Bonifaz et al., 2015).
Physical
Clinical manifestations of tinea barbae relate to the causative pathogen. Two clinical varieties of the disease are identified: inflammatory and non-inflammatory.
Inflammatory deeper tinea barbae is caused primarily by zoophilic dermatophytes. This variety, termed a kerion, is the most common clinical presentation. Most patients show solitary plaques or nodules; however, multiple plaques are relatively common. Usually localized on the chin, cheeks, or neck, involvement of the upper lip is rare. The characteristic lesion is an inflammatory reddish nodule with pustules and draining sinuses on the surface. Hairs are loose or broken, and depilation is easy and painless. Pus-filled whitish masses involve the hair root and follicle. Over time, the surface of the indurated nodule is covered by exudate and crust. This variety of tinea barbae usually is associated with generalized symptoms, such as regional lymphadenopathy, malaise, and fever.
Noninflammatory superficial tineabarbae is caused by anthropophilic dermatophytes. This variety of barbae is less common and resembles common tineacorporis or bacterial folliculitis (sycosiform variety). Typically, erythematous patches show an active border composed of papules, vesicles, and/or crusts. Hairs are broken next to the skin, or they plug the hair follicle. In the sycosiform variety, small follicular pustules are observed. Hairs are broken or loose. This variety represents a chronic variant of tineabarbae. Rarely, one may see tineablepharociliaris associated with tineabarbae(Buruiana et al., 2015).
