Bacteria

Erythrasma

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Erythrasma, Cutaneous Erythrasma, Corynebacterium minutissimum

  • See Also
  • Epidemiology
  1. Accounts for 17% of Bacterial skin Infections in Older Adults
  • Pathophysiology
  1. Caused by Corynebacterium minutissimum, a Gram Positive Rod that is a common skin colonizer
  2. C. minutissimum grows best in moist, hot environments (intertriginous areas)
  3. Regions of Erythrasma are also often coinfected with dermatophytes initially
  • Risk Factors
  1. Similar to risks associated with Intertrigo
  2. Regions with excessive heat and moisture
  3. Comorbidity
    1. Older Adults
    2. Diabetes Mellitus
    3. Obesity
    4. Immunosuppression
    5. Hyperhidrosis
    6. Decreased hygiene
  • Symptoms
  1. Usually asymptomatic
  2. May be pruritic in some cases
  • Signs
  1. Small red-brown, hyperpigmented Macules (may form larger patches)
    1. Minimal Scaling
  2. Distribution in intertriginous areas (moist, macerated areas)
    1. Interdigital web spaces
      1. Most common Bacterial foot infection
      2. Macerated interdigital skin is common
    2. Gluteal crease
    3. Inguinal area
    4. Axilla
    5. Inframammary
  • Diagnosis
  1. Wood's Lamp: Fluoresces coral red
  2. Gram Stain: Gram Positive Rod with long filaments
  • Managment
  1. Antibiotics
    1. Erythromycin 250 mg orally qid for 5 days
    2. Clarithromycin 1 gram orally for 1 dose
  2. Topical Antifungal agents with activity in Erythrasma
    1. Miconazole
    2. Clotrimazole
    3. Econazole
  3. Treat coexisting Fungal Infection (see Intertrigo)
  4. Adjunctive topical agents
    1. Cleocin-T or Erythromycin gel
    2. Whitfield's Ointment
    3. Sodium fusidate ointment
    4. Antibacterial soap
    5. Chlorhexidine (Hibiclens)
  • Prevention