Erythrasma

Erythrasma: Description, Causes and Risk Factors:Erythrasma is caused by the bacteria Corynebacterium minutissimum (A genus of nonmotile (except for some plant pathogens), aerobic to anaerobic bacteria (family Corynebacteriaceae) containing irregularly staining, Gram-positive, straight to slightly curved, often club-shaped rods which, as a result of snapping division, may show a picket fence arrangement. These organisms are widely distributed in nature. The best known species are parasites and pathogens of humans and domestic animals). This bacterium is thought to produce excess coproporphyrins.Currently, there is very little known about the Epidemiology of erythrasma and the nature of porphyrin production by these bacteria.There are also two distinct variants of erythrasma, which are called generalized and interdigital. The interdigital variant is the most common bacterial infection of the feet that presents as fissuring or scaling of the interspaces of the toes without any symptoms. The fissures and scaling most commonly occur between the fourth or fifth digit (little toe) of the feet. The generalized variant is the most common seen in diabetes (diabetes mellitus type II) in which the skin lesions extend beyond the intertrigineous areas.Erythrasma is more common in warm climates. You are more likely to develop this condition if you are overweight or have diabetes.Pathologist observed a 78-year-old woman with erythrasma who had a well-demarcated slightly scaling patch on her left foot, between the fourth and fifth toes. Two kinds of colonies on 5% sheep blood agar were obtained from this lesion. Analysis of the 16S rRNA sequence revealed the colonies to be Corynebacterium aurimucosum and Microbacterium oxydans. HPLC analysis demonstrated that coproporphyrin III (Copro III) levels were clearly elevated, although the amounts of protoporphyrin were diminished. These results indicate that the fluorescent substance was Copro III. This study supports the view that excess Copro III synthesis by C. aurimucosum and M. oxydans leads to accumulation of porphyrin in cutaneous tissue, which emits a coral-red fluorescence when exposed to Wood's light.Symptoms:ErythrasmaThe main symptoms are reddish-brown slightly scaly patches with sharp borders. They may itch slightly. The patches occur in moist areas such as the groin, armpit, and skin folds. The patches often look similar to other fungal infections, such as ringworm.Diagnosis:Diagnosis can be made by a dermatologist using a Wood's lamp in the office. Wood's lamp is a non-invasive diagnostic tool that shines ultraviolet light onto the skin. In erythrasma, a bright coral-red fluorescence is seen when the lamp is shined over the affected area.Other tests that may help include:Gram Stain: A way to identify bacteria from a sample of the scale. Unfortunately, this bacteria is difficult to get to stick to the slide so it requires a special technique.
  • KOH Test: This is a test used to identify fungal elements. This test might be done to confirm that there is no fungus present.
  • Skin Biopsy: A sample of tissue is removed and evaluated under a microscope. In erythrasma, the bacteria can be seen in the upper layer of the specimen.
Treatment:Treatment usually consists of keeping the area clean and dry with antibacterial soaps and aluminum chloride topical solution. An antibacterial solution or cream such as clindamycin HCL solution, erythromycin or miconazole cream can be prescribed to eradicate the bacteria. For a more aggressive treatment, oral antibiotics such as erythromycin can also be used with successful results.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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