Roles of Medicinal Plants in the Diagnosis and Treatment of Mycetoma

Mycetoma is a chronic, progressively destructive infectious disease of the skin and subcutaneous tissues and is recognized as a neglected tropical disease by the World Health Organization. It predominantly affects impoverished populations in tropical and subtropical regions, where limited access to healthcare leads to delayed diagnosis, advanced disease, disability, and amputation. Conventional diagnostic and therapeutic approaches for mycetoma are often invasive, expensive, prolonged, and associated with poor patient compliance, drug toxicity, and high recurrence rates. These limitations necessitate the exploration of alternative and complementary strategies. Medicinal plants have long been used in traditional medicine systems in mycetoma-endemic regions and offer a promising, cost-effective, and culturally acceptable approach to disease management. This review comprehensively discusses the epidemiology, classification, pathophysiology, and current challenges in mycetoma diagnosis and treatment, with a particular focus on the role of medicinal plants. It highlights the potential of plant-derived bioactive compounds in diagnosis, including natural dyes, biomarkers, and low-cost diagnostic assays, as well as their therapeutic roles through antimicrobial, antifungal, anti-inflammatory, immunomodulatory, and wound-healing activities. Key medicinal plants such as Azadirachta indica, Curcuma longa, Allium sativum, Lawsonia inermis, and Nigella sativa are reviewed alongside their phytochemical constituents and mechanisms of action. The review also addresses formulation strategies, safety concerns, standardization challenges, and future perspectives, emphasizing the need for clinical validation and integration of ethnopharmacological knowledge with modern medical approaches. Overall, medicinal plants represent a valuable resource for improving the diagnosis and management of mycetoma, particularly in resource-limited settings.