Abstract: During antifungal evaluation of various plant extracts, free and bound flavonoids of Piper betlewere found to be most effective as an antidermatophytic against human pathogenic dermatophytes Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum gypseum and Candida albicans. Dermatophytic fungi cause both superficial and internal mycoses. These mycoses, although normally not lethal, are unpleasant and difficult to cure and cause considerable financial losses. Earlier workers prove that allopathic drugs are still found effective against dermatomycoses, but these drugs could not be accepted as a routine treatment for every case, because they are expensive and require long treatment. It is almost unaffordable by middle and lower class people. In view of such prospects and constraints, our aim was to explore more new compounds of plant origin for controlling dermatophytic infections. Author explored water, methanolic and flavonoid extracts for screening as antidermatophytic agent. Plant extracts that showed good results in vitro were selected for clinical studies. The study may give cheaper treatment for medium and lower class patients suffering with tinea and may provide them much relief. Well-established paper disc method was used for the screening of different extracts of their antidermatophytic activity. Moreover, it did not exhibit any adverse side effect on mammalian skin. Flavonoids in the form of ointment Pi be I and Pi be II were subjected to topical testing on patients attending out patients department of S.M.S. Hospital, Jaipur, India. Patients were diagnosed as tinea corporis, tinea capitis, tinea manum or tinea pedis. All patients showed positive potassium hydroxide (KOH) results at the beginning of trial. Patients between the ages of 3 months to 58 years were enrolled. At the end of treatment, while 64% of patients cured completely, 24% showed significant improvement and 12% showed little improvement from the disease. Allopathic treatment took 4-8 weeks when compared with only 1-5 weeks taken by Pi be I and Pi be II ointments. The ointment, thus not only showed maximum affectivity but was also found to be a better and cost effective alternative to allopathic drug for tinea infections. The acceptability of alternative medicines, particularly herbal medicines, has now become a critical need of the times.

..........................................................

Trakranrungsie, N., A. Chatchawanchonteera and W. Khunkitti. 2006. Antidermatophytic Activity of Piper betle Cream. Thai J Pharmacol 28, 3: 16-20.

Abstract; Crude ethanolic extracts of Piper betle leaves (Piperaceae), Alpinia galanga rhizomes(Zingiberaceae), and Allium ascalonicum bulbs (Liliaceae) were previously tested against selected zoonotic dermatophytes (Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophyte). The results suggested a promising antifungal property of Piper betle extract 1,2. Therefore, in this present study a 10%Piper betle cream (Pb cream) was formulated, subjected to physical and microbial limit tests, and evaluated for its effect against zoonotic dermatophytes in vitro. The freshly prepared Pb cream (pH~5.0) was dark green with a pungent odor of P. betle leaves. After repeated freeze-thawing, the cream was darkening and markedly thickening. Its pH also increased significantly. No bacterial or fungal contamination was detectedfrom the Pb cream samples. The disc diffusion assay revealed comparable zones of inhibition between discs of Pb cream containing 80 μg P. betle extract and 80 μg ketoconazole against M. canis, M. gypseum, and T. mentagrophyte at 96 hours after incubation. Thereafter, the inhibitory effect of Pb cream markedly decreased and was completely lost by day 7. Meanwhile, the effect of ketoconazole cream reduced gradually but was still effective against M. canis and T. mentagrophyte after seven days of incubation. In summary, the Pb cream has potential therapeutic value for treatment of dermatophytosis. However, clinical testing as well as improving the Pb cream formulation with greater efficacy and duration of action would be of interest and await further investigation.

...................................................................................................................................

Trakranrungsie, N., A. Chatchawanchonteera and W. Khunkitti. 2004. AN IN VITROEVALUATION OF PIPER BETLE SKIN CREAM AS AN ANTI-ZOONOTIC DERMATOPHYTES. The Proceedings of 42^nd Kasetsart University Annual Conference: 441-448

Our previous studies suggested the ethanolic extract of P. betle leaves exhibited antifungal activities with more potency than the extracts of A. galanga and A. ascalonicum. In the present study, the 10%P. betle skin cream (Plu cream) was formulated, subjected to physical and biological control, and tested for the effect against zoonotic dermatophytes in vitro. The Plu cream, slightly acidic, was dark green in colour with a typical smell of P. betle leaves. After ten freeze-thaw cycles, the cream was darkening and markedly thickening. Its pH also increased significantly. No bacterial and fungal contamination was detected from the Plu cream samples. The disc diffusion assay revealed comparable zones of inhibition between 80 mg Plu cream disc and 80 mg ketoconazole cream disc against M. canis, M. gypseum, and T. mentagrophyte at 96 h after incubation. Thereafter, the inhibitory effect of Plu cream markedly decreased and completely loss by day 7. Meanwhile, the effect of ketoconazole cream reduced gradually and was still effective against M. canis and T. mentagrophyte after 7 days of incubation. In summary it was suggested that the Plu cream has potential therapeutic value for treatment of dermatophytosis. However, clinical testing as well as improving the Plu cream formulation with greater efficacy and duration of action would be of interest and await further investigation.