Sir,

Keratin is important and needed for the growth of dermatophytes in the host tissue. In turn, the ability to invade keratinised tissues is defined as a pivotal virulence attribute of this group of medically important fungi. The host-dermatophyte interaction is accompanied by an adaptation of fungal metabolism that allows them to adhere to the host tissue as well as utilize the available nutrients necessary for their survival and growth. Dermatophyte infections pose a significant epidemiological and clinical problem. Trichophyton rubrum is the most common anthropophilic dermatophyte worldwide and its typical infection areas include skin of hands or feet and nail plate [1]. In turn, Microsporum cutis is a human pathogen, and mostly well known for ringworm even in pets.

So, comparing the intracellular metabolite content in the T. rubrum during keratin degradation using liquid chromatography system coupled with tandem mass spectrometer (LC-MS/MS) one states that the metabolite “fingerprints” revealed compounds associated with amino acids metabolism, carbohydrate metabolism related to the glycolysis and the tricarboxylic acid cycle (TCA), as well as nucleotide and energy metabolism. The metabolites such as kynurenic acid, L-alanine and cysteine in case of T. rubrum were detected only during keratin degradation what may suggest that these compounds may play a key role in the interactions of T. rubrum with the host tissue. The metabolomic results were completed by qPCR gene expression assay. Final findings suggest that metabolomic analysis of T. rubrum growing in culture media that mimic the dermatophyte infection could allow the understanding of processes involved in the pathogenesis of dermatophytes.

Now fungal hyphae invade and damage solid organs like kidneys, liver, spleen, lung and brain. The principal target organ involved in disseminated fungal aggressions are kidneys [2,3].

Acute kidney injury (AKI) is often observed in critically ill patients and is associated with high morbidity and the most important metabolyte seems to be kynurenic acid. Non-recovery from AKI has a negative impact on the prognosis of affected patients and early risk stratification seems key to improve clinical outcomes.

It is welknown that in case of many types of fungi belonging to Tinea spp, the catabolytes of the infected areas are retrievable in kidneys under the shape of kynurenic acid that is excreted through urination of the same ill individual.

This fact is crucial to understand the importance of treating topically Tinea pedis manifestations with the ill’s urine itself, and since these metabolic agents must adhere strenuously to the affected skin, it is necessary that urine were dissolved and mixed in a special pharmaceutical liquid apt to do this: the elastic collodion, obtained by mixing solphoric and nitric acids with nitrocellulose and afterwards diluted in aether.

During fungal infection by Trichophyton, Epidermophyton e Microsporum, kynurenine acts on Aryl Hydrocarbon Receptors (AhR) to modulate the production of immune cell sub-populations.

AhR mediate some effects of kynurenine and kynurenic acid on cell growth and differentiation, and represent a central feature of the IDO1-kynurenine-AhR-IDO1 positive feedback system [4,5].

Analysing metabolites of a conserved key inflammatory pathway (i.e. tryptophan degradation pathway) in serial urine samples of patients with AKI [6] is essential to determine the presence of kynurenic acid in individuals suffering from some type of Tinea infections (in this case specifically Tinea pedis, contracted most than probably by the usage of socks infected thanks the presence of pets in very humid circumstances).

Regulatory and functional aspects of the kynurenine (K) pathway (KP) of tryptophan (Trp) degradation are scientifically referred [7].

An art connoiseur, a man (57 y. old, safe presenting his serum creatinine values regular) during a reconnaissance of a very antique edifice where the last and most important Giotto’s masterpiece in a abandoned hamlet close to Florence in Tuscany) after having worn humid socks in old boots for an entire day of work, showed a full blown Tinea pedis (rubor, calor and prurigo).

The AA previously prepared a combinaison of collodion and aether and mixed it with the urine itself of the volunteer.

They prayed the man to spread this vanishing and plastifying solution twice a day on the afflicted foot for three days.

After the 6^th application no skin manifestation in the foot of the art connoiseur who had contracted Tinea pedis was more evident.

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