Grading & Level of Importance: A
Superficial infection with diphtheroid bacteria mostly affecting intertriginous areas.
Aetiology & Pathogenesis
Most infections are caused by Corynebacterium minutissimum.
Predisposing factors include obesity, diabetes, profuse sweating, occlusive clothing and a warm humid climate.
Signs & Symptoms
Sharply demarcated, red-brown, scaly patches, occasionally pruritic.
Axillary, inguinal, toe clefts. Occasionally sub-mammary areas or extensive.
Interdigital erythrasma, intertriginous erythrasma, generalized/disciform erythrasma.
Laboratory & other workups
Orthokeratosis with a minimal perivascular infiltrate in H&E staining. Gram staining shows positive rods and filaments in the stratum corneum.
Chronic or recurs frequently.
Scratching with secondary infection with other microbes.
Wood's light: coral red fluorescence (porphyrins from bacterial metabolism), culture (difficult).
Prevention & Therapy
Topical treatment including antiseptics, ciclopirox, or imidazoles (clotrimazole, econazole), sometimes antibiotics (erythromycin). Severe cases can be treated with oral antibiotics (tetracycline, clarithromycin). Disappearance of red fluorescence indicates therapeutic success, hyperpigmentation may persist.
Avoid provoking factors (see above).
Further Images / DOIA
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