Cold sub‐atmospheric and atmospheric pressure plasma for the treatment of Trichophyton rubrum onychomycosis: An in‐vitro study

Abstract

Previous studies have suggested the applicability of cold atmospheric pressure plasma for the treatment of onychomycosis. Whether delivering cold plasma in subatmospheric pressure would be beneficial for this purpose is yet to be established. The current study aimed to evaluate efficacy of cold sub-atmospheric and atmospheric pressure plasma in Trichophyton rubrum growth inhibition. Bovine nails infected with T. rubrum were treated by a cold air plasma device, which enables utilizing plasma in sub-atmospheric pressures (Low = 100 millibar; High = 300 millibar) or atmospheric pressure. The infected foci were exposed to the plasma source directly or indirectly. Treatment with high sub-atmospheric pressure setting achieved T. rubrum growth reduction of 94.0% and 73.0%, for direct and indirect exposure to the plasma source, respectively (P < .001). Low sub-atmospheric pressure setting achieved similar T. rubrum growth reduction of 86.2% for direct exposure to the plasma source (P < .001), but only marginally significant 58.8% reduction rate for indirect exposure to the plasma source (P = .056). None statistically significant fungal growth reduction was attained with the use of atmospheric pressure setting. Cold plasma was shown to effectively inhibit T. rubrum nail growth, with sub-atmospheric pressure setting achieving better outcome than atmospheric pressure.

Treating hard‐to‐heal skin and nail onychomycosis of diabetic foot with plasma therapy

“… 3 Plasma care® is compact size and individually packaged sterile attachment to prevent cross‐contamination. 4 This is because plasma treatment is easy to perform and has few side effects. During the first week of treatment, a para‐medical treated the patient and taught her how to use plasma care®.…”

Cold atmospheric plasma therapy for Malassezia folliculitis: Laboratory investigations and a randomized clinical trial

“… 8 Studies on dermatophyte fungal infections demonstrated that CAP suppresses the growth of Trichophyton rubrum , Epidermophyton floccosum , Microsporum canis , Microsporum gypseum , and Candida albicans by disrupting fungal spores and cell membrane integrity. 9 , 10 , 11 As a physical therapy modality without promoting fungal resistance or triggering allergic or toxic reactions, plasma treatment combined with nail plate abrasion and refreshment achieved clinical and mycological cure rates of 70.0% and 85.7%, respectively, in patients with onychomycosis. 12 A controlled split‐face study on acne patients demonstrated improved aesthetics on the treated side, with 79% of patients reporting enhancement compared to 45% on the untreated side.…”

“…CAP effectively inhibits various skin microorganisms, including viruses, bacteria and fungi, through the generation of reactive oxygen and nitrogen species 8 . Studies on dermatophyte fungal infections demonstrated that CAP suppresses the growth of Trichophyton rubrum , Epidermophyton floccosum , Microsporum canis , Microsporum gypseum , and Candida albicans by disrupting fungal spores and cell membrane integrity 9–11 . As a physical therapy modality without promoting fungal resistance or triggering allergic or toxic reactions, plasma treatment combined with nail plate abrasion and refreshment achieved clinical and mycological cure rates of 70.0% and 85.7%, respectively, in patients with onychomycosis 12 .…”