Definition and cause
Dermatophytosis is a cutaneous fungal infection caused by Mycosporum canis and other dermatophte fungi. This fungal infection is contagious, and generally the only clinical manifestation is hair loss and a crusted lesion. Other fungi can cause infections, which can also become systemic and can cause disease in other organs, such as the sinus and the lungs.
Medical therapy rationale, drug(s) of choice, and nutritional recommendations
Systemic treatment with Griseofulvin, Ketoconazole, and Itraconazole are often prescribed. While fairly effective, they have potential side effects such as anemia and white blood cell suppression (with Griseofulvin) and hepatopa-thy (with Ketoconazole and Itraconazole). Topical cleaning, clipping the hair, and applying topical agents such as lime sulfur is also effective.
Most infestations are self limiting and the prognosis is good.
Integrative veterinary therapies
According to the American Academy of Allergy, Asthma and Immunology, sinusitis in humans and fungal infections are on the rise. This indicates that the common treatments, e.g. antifungals, are not getting to the root of the problem, which is not caused by infection, but is actually an immune disorder caused by fungus. Researchers have found that fungal organisms were present in the mucus of 96% of patients who had surgery for chronic sinusitis, and inflammatory cells were clumped around fungi, suggesting an immune disorder caused by fungus.
This is easy to comprehend when we consider that mold spores contain numerous digestive enzymes that directly attack and damage tissue. A healthy immune system should be able to aggressively defend itself against mold spores. Direct damage by fungal spores coupled with environmental toxins is a perfect formula to initiate allergic responses. As this damage progresses we see an excellent example of progressive vicariation, which rapidly can attain the Degeneration Phase and may predispose to Degeneration Phase disease processes (see Homotoxicology, General Considerations).
In the veterinary field, we see an array of fungal conditions, not only in the skin but also systemic forms, and as the body attempts to destroy the fungus, the immune system damages the surrounding tissues. The integrative approach to such fungal infestations, either local or systemic, is to reduce exposure to infectious agents, support immune function, and improve and enhance the elimination of toxins from the body.
General considerations / rationale
The nutritional support used to address fungal infection is usually done in combination with medical therapy, although in this approach, topical medication is preferred. The therapeutic nutritional approach is to help reduce inflammation locally and balance and enhance immune function systemically.
Some approaches to fungal infection involve dietary changes, because high-carbohydrate diets may contribute to fungal overgrowth, and supplementing with a high level of omega-3 fatty acids can improve immune function. Several foods rank high on the list for dietary avoidance, including: corn, which is highly contaminated with fumonisin, aflatoxins, and other fungal toxins (Council for Agricultural Science); wheat and wheat products, because wheat is often contaminated with mycotoxins; barley; cottonseed; sugar cane; sorghum; and sugar beets.
Many disease entities have been linked to fungal overgrowth. To learn more about their sources, read Diseases Caused by Fungi and Their Mycotoxins by Costantini (see Product Sources).
Nutrition / gland therapy: Glandular therapy support of the skin as well as the immune system organs (adrenals, thymus, and lymph) is indicated (see site, Gland Therapy, for additional information).
Quercetin: Quercetin is in the flavonoids family (see site, Phytonutrients). It functions like an antihistamine and has antioxidant properties. It has been shown to inhibit cells from releasing histamines, so it is beneficial in the treatment of allergic conditions such as dermatitis, eczema, and asthma.
Phosphatidyl choline: This phospholipid is integral to cellular membranes and is an essential nutrient for healthy skin.
Evening primrose oil: evening primrose oil has been proven to have both antiinflammatory and antipruritic effects and, as part of a balanced nutritional program, can exert a positive effect on animals with skin disease. Studies suggest that evening primrose oil is beneficial in people with atopic dermatitis and eczema.
Chinese herbal medicine / acupuncture
General considerations / rationale
Fungal infections are a result of Wind, Heat, and Damp invading the body. Wind blows the pathogen into the body. Heat and Damp refer to the inflammation and moist skin lesions, respectively. Treatment is aimed at eliminating the pathogen, clearing inflammation, and preventing secondary bacterial infections.
Appropriate Chinese herbs
Anemarrhena rhizome (Zhi mu): Has demonstrated inhibitory effects against some dermatophytes and some bacteria, including Staphylococcus aureus. This herb can attack the primary pathogen while simultaneously preventing secondary bacterial infections.
Angelica root (Dang gui): An immunostimulant that may help the patient eliminate the infection.
Arctium (Niu bang zi): Inhibits bacteria, including Staphylococcus aureus and beta streptococcus, and various fungi (Group of Internal Medicine, Group of Virology).
Atractylodes rhizome (Cang zhu): Inhibits Staphylococcus aureus and some dermatophytes. It can decrease xylene-induced ear swelling and carrageenin-induced foot swelling. It may decrease the inflammation associated with fungal infections.
Gypsum (Shi gao): Has dual activities of decreasing inflammation and stimulating immunity. It increases the phagocytic activity of macrophages. At the same time it decreases inflammation. In 1 trial 126 human patients with various inflammatory disease processes were treated with gypsum. Most showed improvement.
Licorice (Gan cao): Can inhibit Staphylococcus aureus.
Rehmannia (Sheng di huang): Reduces swelling and inflammation.
Schizonepeta stem (Jing jie hui): Decreases acute and chronic inflammation.
Siler (Fangfeng): Inhibits Staphylococcus aureus.
Sophora root (Shan dao gen): Increases IgM and IgG levels. It also has antibiotic activity.
General considerations / rationale
Fungal infections may occur if an overwhelming amount of infectious fungal agent gains access to the body. Simple dermatophytosis is a Reaction Phase disorder, while chronic, recurrent, or refractory cases indicate more serious systemic involvement.
Immune suppression by a wide variety of causes predisposes to fungal infection as does residing in a contaminated area. Systemic mycoses involve both of these factors. Many fungal infections occur following compromise of the greater defense system and are more common in Deposition, Impregnation, Degeneration, and Dedifferen-tiation phases. Yeast infections are commonly associated with allergic disorders, wherein homotoxins accumulate and alter the connective tissue’s responses.
Homotoxicology agents are viewed as additional therapy in these cases, because antifungal drugs are both important and useful in treating systemic and topical forms. However, the clinician must remember that these drugs are homotoxins and can cause further damage to the body, particularly the liver and kidney. No cases of successful use of antihomotoxic therapy could be found in the veterinary literature at this time, but one case of feline cryptococcal encephalitis was treated successfully using an integrative approach by the author.
Appropriate homotoxicology formulas
The best known of the classical homeopathic remedies for fungal infection / dermatophytosis are: Sepia for brown, scaly patches; Tellurium for prominent, well-defined, reddish sores; Graphites for thick scales or heavy discharge; and Sulphur for excessive itching.
BHI-Allergy: A remedy that contains Arnica for itching, burning skin, and a host of other remedies for skin irritations and eruptions. It also contains, most notably, Tellurium metallicum, which is mentioned in classical repertories. Marked skin (Herpes circinatus) is another indication for this remedy, as is a very sensitive back, itching of hands and feet, herpetic spots, ringworm (Tuberc), ringshape lesions, offensive odors from affected parts, and circular patches of eczema. Lesions tend to be equally distributed on either side of the body. Also recommended for Pityriasis versicolor and eruptions — herpetic. BHI-Allergy also contains Graphites (see Graphites homaccord) and Sulphur (see Sulphur heel and Engystol N).
BHI-Skin: A good support remedy that includes Rhus Toxicodendron (also in Aesculus compositum, Arnica-Heel, Echinacea compositum, BHI-Inflammation, BHI-Skin, et. al.) Rhus toxicodendron (poison ivy) contains rhoitannic acid. A component of the sap, urushiol, is a strong skin irritant. It has been recommended for violent itching, and possibly for an eruption like measles all over the body, a vesicular eruption (herpes), a crusty eruption on the head, and eruptions of a vesicular nature, particularly when the eruptions are bluish-grey in color. It is one of the main remedies for Herpes zoster. However, Rhus toxicodendron is also valuable in chronic skin diseases, especially in eczema with vesicle formation. It is also a main remedy for facial and frontal impetigo if there is violent itching. This remedy also contains Graphites (see Graphites homaccord) and sulphur (see Sulphur-Heel and Engystol N).
Coenzytne compositum: Provides metabolic support and repair of damage to mitochondria by therapeutic agents.
Cutis compositum: Provides support and drainage of the skin and associated adnexa. This remedy is of huge value in skin disorders, as one might expect from the name. It contains Cutis suis, for which the principal indications are: allergic reactions, dermatoses, eczema, seborrhea, dermatomycoses, neurodermatitis, and other chronic problems. It also has Hepar suis (found in Hepar compositum, Syzygium compositum, Thyre-oidea compositum, Tonsilla compositum, etc.) for chronic eczemas, neurodermatitis, psoriasis, erythemas, dermatomycoses, and eruptions that are papular or in blotches which itch and that appear on the head, face, back, female genitalia, or extremities. It also contains Sulphur (see Sulphur Heel) and Graphites (see Graphites Homaccord). The ingredient Thuja can also be of value in chronic skin conditions. The oil from the red cedar, from which Thuja is taken, is known as an antifungal agent.
Echinacea compositum: Provides immune support in Reaction and Impregnation phases.
Galium-Heel: Contains Aurum metallicum, which has been used successfully in a case of Feline Aspergillosis (Hoare).
Graphites homaccord: Used to treat dry, crusty or weepy patches of pigmented dermatitis. Graphites (also found in BHI-Allergy, BHI-Skin, Cutis compositum, Placenta compositum, Thyroidea compositum, Tonsilla compositum, etc.) shares indications with Carbo vegetabilis and other antipsorics, particularly Sulphur. There is a tendency toward the formation of cracks, and to various skin diseases, proceeding with crusty eruptions and the discharge of a sticky, honey-like fluid, which hardens into scabs. These are often localized in the folds and creases of the skin. Itching is aggravated by heat. There may be general loss of hair, which is hard and brittle, and alopecia areata, and possibly chronic ear discharge smelling like herring-brine.
Graphites, as a constituent, is also a remedy indicated for eczema capitis, fissures in general, intertrigo and fungal infections of the nails, and psoriasis on fingertips, nipples, corners of the mouth, and between the toes. Another important constituent, Sepia (in BHI-Skin and others) is one of the most frequently needed homeopathic remedies, and is mainly used for chronic diseases and dyscrasias (i.e., both cellular and also chronic humoral phases such as chronic eczemas and chronic discharges such as leucorrhoea). Worthy of particular note are the skin symptoms of Sepia, namely soreness and itching, which is frequently transformed into burning as a result of scratching (cf. Sulphur), with localization in the creases of the knees. These patients may show large, suppurating pustules, which repeatedly relapse; brown patches on the face, chest, and abdomen; and vesicles and scabies-like conditions, particularly if Sulphur has not completed the cure. The skin symptoms may express in the form of pustules, eczema, neurodermitis, herpes, yellowish-brown scaly patches, or sloughing of the epidermis in round patches on the hands and fingers, possibly associated with painless ulcers. Chronic dermatophytosis is another condition that may respond to this remedy.
Lymphomyosot: Used in lymph draining and in eczema.
Psorinoheel: A phase remedy in Excretion Phase disorders and in chronic, constitutional cases. One of the most useful components is Bacillinum, which is used in eczema and impetigo and is indicated in alopecia. It is useful for Pityriasis versicolor and other skin disorders, as well as general weakness and debilitation. The ingredient Bufo has been used for purulent blisters (pemphigus) on the skin and mucosa, and for paronychia and glandular and dermal inflammations accompanied by a tendency toward suppuration.
Psorinum nosode (also in Tonsilla compositum (was introduced into the homeopathic Materia Medica by Hering in 1833-34, and was the first nosode to be so included. It is said to be useful in chronic and acute eczemas with violent itching, especially at night, that is relieved by scratching until it bleeds. Other skin dyscrasias also respond well to intercurrent doses of Psorinum. According to some popular materia medicas, there is a wide variety of relationships with well-known polychrests, such as: Arsenicum album (complaints and restlessness at night, fear of death, desquamating skin eruptions); Petroleum (dry skin with cracks and oozing eruptions); and Sulphur, which is the most closely related remedy regarding discharges, burning of the skin, eruptions, vicarious conditions, and general chronicity. Thus, it is appropriately used in chronic eczema, impetigo, all kinds of skin eruptions, asthma alternating with eczema, psoriasis, boils, acne, seborrhoea, etc. Also contains Sulphur (see Sulphur-Heel, Engystol N, and Scbwef-Heel).
Schwef-Heel A Sulphur-containing remedy for red, itchy skin. It is used as a catalyst, and is given intermittently in skin conditions. This is a homaccord of Sulphur, which has deeper reaching potencies than other antihomotoxic formulas.
Sulphur-Heel: Named for Sulphur, one of the most important single remedies in homeopathy. This is easily appreciated when one discovers the number of antihomotoxic agents that contain it, such as Causticum compositum, Cutis compositum, Echinacea compositum, Engystol, Ginseng compositum, Hepar compositum, Mucosa compositum, Psorinobeel, Pulsatilla compositum, Scbwef-Heel, Tbyreoidea compositum, Tonsilla compositum, BHI-Allergy, BHI-Enzyme, BHI-Skin, and many others.
Typical of Sulphur indications in Impregnation phases is the affection of the skin, which itches and then burns after being scratched. The body is trying to eliminate intermediate homotoxins, particularly histamine, via the skin, causing a wide variety of discharges, which are excoriating and cause reddening of the orifices and an offensive body odor. Sulphur should be given intercur-rently, e.g. as an intravenous injection, in cases that do not respond to well-indicated biotherapeutic or antihomotoxic remedies. This should be done regardless of the system, e.g. chronic heart disease; skin diseases such as lichen planus, acne vulgaris, eczema, neurodermitis, and dermatoses; and liver disease..
This combination also contains a variety of remedies that are useful in itchy, eczematous, eruptive skin lesions, such as Caladium, Pix liquida, Mezereum, Arsenicum, and others.
Tonsilla compositum: Provides immune support in Impregnation, Degeneration, and Dedifferentiation phases. It contains Conium (also in Ginseng compositum, Testis compositum, Thyroidea compositum, Ubichinon compositum, and others), which is used for glandular swellings and induration, prickling and stinging, and conditions that are stonyhard to the touch. Tonsilla compositum also contains the aforementioned Graphites, Hepar suis, Psorinum, and Sulphur. Funiculus umbicalis suis is included for regeneration of damaged tissues.
Traumeel S: Used as a phase remedy and in cases of regulation rigidity.
Authors’ suggested protocols
Skin and immune support formulas: 1 tablet for every 25 pounds of body weight BID.
Lymph support formula: One-half tablet for every 25 pounds of body weight BID.
Quercetin: 50 mg for every 10 pounds of body weight SID.
Lecithin / phosphatidyl choline: One-fourth teaspoon for every 25 pounds of body weight BID.
Oil of evening primrose: 1 capsule for every 25 pounds of body weight SID.
Chinese herbal medicine / acupuncture
The patent formula is Xiao Feng San. It contains 3 g each of angelica root (Dang gui), rehmannia (Sheng di huang), siler (Fang feng), cicada (Chan tui), anemarrhena rhizome (Zhi mu), sophora root (Shan dao gen), sesame seeds (Hei zhi ma), schizonepeta stem (Jing jie hui), atractyloides rhizome (Cang zhu), arctium (Niu bang zi), and gypsum (Shi gao), and 1.5 g of licorice (Gan cao) (Handbook of traditional Chinese medicine Practitioners). It is dosed according to the supplier’s recommendations.
(Dose: 10 drops PO for 50-pound dog; 5 drops PO small dog or cat)
Graphites homaccord, Psorinoheel, Cutis compositum autosanguis: Give every 2 to 4 weeks, as needed.
Echinacea compositum: Give every 3 days orally.
Hepeel compositum: Give every 3 days.
Coenzyme compositum and Ubichinon compositum: Give on alternate days.
Detox Kit and Galium-Heel: Give daily BID PO for 30 days, possibly with the aforementioned autosanguis mixed in.
Echinacea comp forte, Traumeel plus Mucosa compositum and Chelidonium homaccord (for intestinal mycosis): Injected e.o.d., preferably as an autosanguis. European practitioners have reported good results from this combination.
Skin, immune, and lymph support formulas: Animal Nutrition Technologies. Alternatives: Immune System Support — Standard Process Veterinary Formulas; Immuno Support — Rx Vitamins for Pets; Immugen — Thorne Veterinary Products; Derma Strength — Vetri Science Laboratories; Canine Dermal Support — Standard Process Veterinary Formulas.
Quercetin: Source Naturals; Quercetone — Thorne Veterinary Products.
Lecithin / phosphatidyl choline: Designs for Health.
Oil of evening primrose: Jarrow Formulas.
Chinese herbal medicine
Patent formula: Xiao Feng San — Mayway.
BHI / Heel Corporation