Exploring the Comparative Efficacies of Allopathic and Homeopathic Treatments in Reducing Dermal Malassezia Folliculitis

Malassezia folliculitis is a condition in which the naturally occurring yeasts on the skin proliferate within the sebaceous glands and cause inflammation. The lipophilic Malassezia yeasts colonize the sebaceous glands of the skin and havoc on the skin, leaving patients and dermatologists alike, unhappy. The issue is further exacerbated by a lack of research on the comparative efficacies of treatment types alternative to those heavily implemented in the public sphere, such as allopathic and homeopathic medicines. This paper seeks to narrow this knowledge gap and identify potentially more efficacious treatments to eradicate MF than those already recognized by the public domain. Thus, such will be executed through a two-part, quantitative correlational study that investigates response to both conventional and alternative treatment types to determine the most efficacious type of treatment for eradicating or reducing MF. To encompass a personal and professional perspective, a questionnaire was distributed to patients who have suffered or are currently suffering from MF (the Patient Survey) and dermatologists who have treated or are currently treating patients with MF (the Dermatologist Survey). The data produced from both surveys (though more heavily supported by the Patient Survey as there were more responses) ultimately suggested that a combination treatment may be most ideal- a routine that incorporates both allopathic and homeopathic treatments taken both orally and topically.

The Concordance of Three Diagnostic Test for Malassezia folliculitis using Potassium Hydroxide 20% + Blue-Black Parker Ink, May Grunwald Giemsa, and Potassium Hydroxide 10% + Chicago Sky Blue

Background: Malassezia folliculitis is a pilosebaceous follicular infection disease caused by Malassezia species. There are many misdiagnosed Malassezia folliculitis cases, causing the maladministration of therapy. A routine diagnostic test performed for Malassezia folliculitis cases is the identification of fungal elements (spore) with a microscope using potassium hydroxide, but it has several weaknesses. Purpose: To evaluate the suitability of Malassezia folliculitis diagnostic test using Potassium Hydroxide 20% + Blue-Black Parker Ink, May Grunwald Giemsa, and Potassium Hydroxide 10% + Chicago Sky Blue. Methods: Analytic observational study conducted in the Dermatomycology Division of Dermatology and Venereology outpatient clinic, Dr. Soetomo General Hospital Surabaya. The samples were thirty patients with clinical features of Malassezia folliculitis. The research material was obtained from the body as many as three pieces of papulomoluscoid lesion extracted. The material obtained was then divided into three glass objects for Potassium Hydroxide 20% + Blue-Black Parker Ink, May Grunwald Giemsa, and Potassium Hydroxide 10% + Chicago Sky Blue staining. Result: The identification of spores using Potassium Hydroxide 20% + Blue-Black Parker Ink was 90%, May Grunwald Giemsa was 90%, and Potassium Hydroxide 10% + Chicago Sky Blue was 93% with a value of κ=0.348 and p=0.051. The diagnostic values of May Grunwald Giemsa and Potassium Hydroxide 10% + Chicago Sky Blue were 96.6% sensitivity, 33.3% specificity, 92.9% Positive Predictive Value, and 50 % Negative Predictive Value. Conclusions: There was no significant concordance between May Grunwald Giemsa and Potassium Hydroxide 10% + Chicago Sky Blue with Potassium Hydroxide 20% + Blue-Black Parker Ink in establishing the diagnosis of Malassezia folliculitis. Potassium Hydroxide 20% + Blue-Black Parker Ink is still needed as a routine examination in cases with clinical features of Malassezia folliculitis.

Retrospective Study: Malassezia Folliculitis Profile

Background: Malassezia folliculitis (MF) is a chronic infectious disease of pilosebaceous follicles caused by Malassezia sp. Clinical features of MF include erythematous papules and itchy perifollicular pustules, especially on the upper body, neck, upper arms, and face. The disease is usually reported on adolescents. Objective: To evaluate the profile of MF patients in four years (2014-2017) period in the Mycology Division of Dermatovenerology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya. Methods: This study was a retrospective study to examine the medical records of MF patients in the Mycology Division of Dermatovenerology Outpatient Clinic General Academic Hospital Dr. Soetomo Surabaya from January 2014 to December 2017. Results: The number of new MF patient visits during 2014-2017 was 196 patients, and the average annual visit was 55 patients in 2014, 49 patients in 2015, 65 patients in 2016, and 27 patients in 2017. The majority of patients were males, were aged 15-24 years old. The chief complaint was reddish papules accompanied by moderate itching in the predilection area and most often found in the upper body. The Wood's lamp examination revealed greenish-yellow color, and 20% KOH examination showed spores. Most systemic therapies was ketoconazole and tretinoin 0.05% cream for topical therapy. Conclusions: There was a decrease in the number of MF patients. The diagnoses of MF were based on history taking, physical examination, 20% KOH, and Wood's lamp.

The ROLE OF HERBAL ANTIFUNGAL AGENTS FOR THE MANAGEMENT OF FUNGAL DISEASES: A SYSTEMATIC REVIEW

Nowadays, fungal infection of skin is one of the most common dermatological problems worldwide. It has been investigated that 40 million people suffer from fungal infections. Superficial and subcutaneous fungal infections affect the skin, keratinous tissues, and mucous membranes. The dermatophytic infections, superficial candidiasis of the mouth, skin, or genital tract and infections due to Malassezia, such as pityriasis versicolor and Malassezia folliculitis are the main afflicting conditions. Systemic fungal infections may be caused by either an opportunistic organism that infects an at-risk host or may be associated with a more invasive organism or may be endemic to a specific geographical area. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. but other fungi such as non-albicans Candida spp. are increasingly important in causing systemic fungal infections. There are numerous antifungal agents used clinically to treat fungal infections, i.e., azoles, allylamines, echinocandins, griseofulvin, and flucytosine. The course to modern treatment has not been without its problems and complications, particularly the drug resistances. Phytochemistry of various plant species has indicated that the phytochemicals could be a better source of medicine as compared to synthetically produced drugs. Natural medicines from a plant origin are still used as therapeutic agents, especially for treating bacterial, fungal, viral, protozoal, helminthic infections, etc. This review focuses on the use of plant constituents to prevent fungal infections caused by various pathogens. Hence, it will be proved beneficial for the drug industries.