Does South Africa hold the key to the development of alternative treatments for resistant dermatophyte infections? A review

Background Dermatophyte infections are becoming increasingly prevalent in humans. Limited availability of antifungal agents and the increasing number of treatment failures have motivated research for therapeutic alternatives, which can be developed as potential antifungal agents. Medicinal plant extracts have been proposed as alternative treatments and scientists are seeking medicinal plant species that could be developed into medicines for various skin diseases including fungal skin infections. South Africa has a rich diversity of indigenous medicinal plants with dermatological therapeutic relevance. Aim This study aimed to review research that have documented the use of medicinal plants indigenous to South Africa in the treatment of fungal skin infections with a view to identify plants with the potential for further therapeutic development. Methods Computerized literature searches were performed on databases MEDLINE, SCOPUS, GOOGLE SCHOLAR, MEDLINE EBSCOHOST, SCIENCE DIRECT, Global Electronic Thesis and Dissertations (ETD) and South African National ETD. Results Fifteen medicinal extracts were identified as having significant antifungal activity. This is of significant importance as most fungal pathogens are developing resistance to conventional synthetic antifungal agents. Conclusion This review identified a diversity of South African medicinal plant species which have the potential to be developed for the treatment of fungal skin infections. These medicinal plants offer a safe alternative to synthetic antifungals currently used, particularly since they are less toxic, readily available, and are supported by indigenous and traditional knowledge systems.