Brazilian Green Propolis Extracts Improve Tinea pedis interdigitalis and Tinea corporis

Abstract

Dear Editor:

We report about the antimycotic effect of Brazilian green Propolis extracts (BPE) in 7 Congolese students and school staff with Trichophyton rubrum–caused Tinea pedis interdigitalis (TPI) and Tinea corporis (TC). TPI is a fungal infection of the toe web mostly caused by T. rubrum, Trichophyton mentagrophytes, and Epidermophyton flocosum, and is believed to affect 70% of the world's population at some point in their lives; itching is a common complaint.^1

–4 A number of in vitro studies and animal experiments have reported the antifungal activity of Propolis against different types of dermatophytosis agents; however, clinical trials on TPI in humans are rare.^5,6

Patients with moderate to severe T. rubrum–caused TPI (6 cases) and TC (1 case) confirmed by culture (Sabouraud's Dextrose Agar) were treated with the following topical treatments: 100 mg/mL ethanolic extract of BPE (3 patients, including 2 TPI patients and 1 TC patient); 2% Miconazole (2 TPI patients), and petroleum jelly (2 TPI patients). They were among 523 school children and staff with skin disorders, treated during a 5-month dermatological screening in five schools of Bas-Congo province, Democratic Republic of Congo. Written informed consent was obtained for each patient. Classification of disease severity was performed as previously described,⁷ based on a 0–3 score (0=none; 1=mild; 2=moderate; 3=severe) of the following signs and symptoms: erythema, desquamation, pruritus, vesiculation/postulation, and incrustation. T. rubrum was isolated in all patients by culture. A significant reduction of the overall clinical severity score of TPI and TC signs and symptoms was observed in BPE and Miconazole-treated patients as compared to petroleum jelly (p<0.001, unpaired t test).

A statistically significant difference was observed between BPE and Miconazole-treated patients in terms of clinical severity score for desquamation, incrustation, erythema, pruritus (Fig. 1A–D), and vesiculation/pustulation (Fig. 1E) (p<0.05) as compared with petroleum jelly–treated patients. Furthermore, BPE treatment had a slightly better effect, but not significantly, in relieving skin desquamation and pruritus within the first week of treatment.

FIG. 1.

Percentage reduction of mean severity score for Tinea pedis interdigitalis signs and symptoms: Incrustation (A), desquamation (B), pruritus (C), erythema (D), and vesiculation/pustulation (E). *p<0.001 by unpaired t-test. The figure shows that both topical administration of Brazilian green propolis extracts and Miconazole have significantly improved all T. pedis interdigitalis and Tinea corporis skin symptoms (incrustation, desquamation, pruritus, erythema, vesiculation, and pustulation) as compared to petroleum jelly (p<0.001).

In addition, a relatively better effect of Miconazole was noted, but not significantly, in improving vesiculation/pustulation and incrustation as compared with Propolis (p>0.05). No side-effects were observed in both BPE and Miconazole-treated patients throughout the treatment period. Futhermore, white blood cell assay performed on day 14 showed a significantly lower number of leukocytes in BPE and Miconazole-treated patients (versus petroleum jelly, p<0.05; χ² test) (data not shown).

Propolis is one of the bee products used by various cosmetic industries and food supplement producers. Its efficacy against T. rubrum and other fungal agents has been demonstrated in in vitro studies.^6,8 This report shows that the ethanolic extract of Brazilian green propolis markedly improved TPI and TC within 2 weeks of treatment; thus, it may serve as an alternative antimycotic agent in the management of T. rubrum–caused mycosis. However, conducting a study with larger number of participants would be more conclusive.

Footnotes

Acknowledgments

The authors thank The Yamada Bee Farm staff, Professor Anselme Mbenza Muaka, Mr. Vumi Kiaku Samuel, Ms. Rachel Tona Bilongi, R.P. Daniel Maneka Walongwa, R.P. Antoine Tusamba, and Mr. Alpha Kingo Ngasaki and the staff of Centre Medical La Fraternité and Centre de Santé Kinzundu for their wonderful support.

This study was supported by the Yamada Bee Farm grant for research 2010.

Disclosure Statement

No competing financial interests exist.

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