Dermatophytes, dermatophytosis in the Caribbean and potential for herbal therapy

Introduction: Dermatophytes are a group of morphologically related keratinophilic fungi that invade keratinized tissue (skin, hair, and nails) of humans and warm-blooded animals to produce clinical lesions (dermatophytosis). Clinical lesions are traditionally divided according to the site infected, namely, scalp (tinea capitis), feet (tinea pedis, commonly called “athletes’ foot”), groin, inner thighs, or buttocks (tinea cruris, commonly called “jock itch”), beard (tinea barbae), hands (tinea manuum, toe nails or finger nails (tinea unguium, also called onychomycosis), face, non-bearded area (tinea faciei) and other parts of the body, such as arms, abdomen, or legs (tinea corporis). Dermatophytosis is common world-wide and is caused by species of three genera of dermatophytes, namely Microsporum, Trichophyton, and Epidermophyton. This study presents an update of ecology of different species of dermatophytes and epidemiology of infections caused by them in the Caribbean. Possibility of herbal therapy of these infections as an alternative treatment is also dealt with. Methods: A thorough search of literature was made using PubMed, MEDLINE, Biomed Lib, Med Facts, and different sets of key words, viz. dermatophytes, tineas in Caribbean, occurrence in animals, soil etc. Results: It was revealed that incidence of dermatophytic infections and their epidemiologic characteristics depend on social, geographic, and environmental factors and may change with passage of time. For instance, prior to year 2000, the major cause of tinea capitis in North America for 100 years was Microsporum canis followed by M. audouinii; Since 1950 Trichophyton tonsurans has advanced from Mexico and the Caribbean to be currently a major cause of tinea capitis in North America. The two dermatophytes Microsporum gypseum and M. fulvum, and several Chrysosporium species have been frequently isolated form soils in different countries in the Caribbean. Conclusions: There is almost complete lack of information on human infections due to dermatophytes in several Caribbean countries. The preponderant occurrence of M. fulvum in Anguilla soils with comparatively rare isolation of M. gypseum is a significant observation. The need for further epidemiological studies on dermatophyosis in the Caribbean countries cannot be overemphasized.