Asthma and Toenail Fungus

So  your feet can affect your lungs?

This is actually an old notion and data continue to gather to suggest that it may be true.  The thought process is that molds grow under the toenails and the body develops an allergy to them  The same mold may colonize the airways and the allergy response there leads to asthma. We see the same process in the well recognized diseases Allergic Bronchopulmonary Aspergillosis and Allergic Bronchopulmonary Mycosis.

The fungus that grows under the toenails is called trichophyton (try-co-FY-ton).  A recent study from Japan published in the Journal, Chest, showed that asthmatics with allergy to trichophyton were much more likely to have severe disease than asthmatics without trichophyton sensitivity.  Older studies have suggested that severe asthmatics with trichophyton sensitivity derive benefit from antifungal treatment.

If you have asthma that is not responding to the usual treatment, it may be time to take a look at your feet.

Dr. O

Preservative Allergy

Many of my patients wonder whether preservatives are playing a role in their allergies, particularly hives.  This was a hot topic in the allergy world in the 80’s and early 90’s.  The most commonly implicated preservative was sodium metabisulfite, which is found in a wide variety of foods.  Because it is so common, it became a target for unexplained, chronic hives.  When it was studied using blinded, placebo-controlled oral challenges, very few true reactions were observed. Both Dr. Norvell and I trained at Vanderbilt where we had the occasion to supervise many such challenges.  Since many people remain concerned about reactions to metabisulfite and other preservatives, at the AAAMT we  canperform blinded, placebo-controlled oral challenges if the situation warrants.   This remains the gold standard way to evaluate for the presence of preservative, and other, allergies.