Erythrasma

Definition:
Erythrasma is a bacterial infection caused by the bacteria Corynebacterium minutissimum. It occurs most often between the third and fourth toes, but it can also frequently be found in the groin, armpits, and under the breasts. Because of it’s color and location, it’s often confused with a fungal infection like jock itch. Erythrasma is more common in the following populations:

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It is prevalent among diabetics, the obese,elderly, and People in warm, moist climates   and is worsened by wearing occlusive clothing.

Symptoms:
The main symptoms are reddish-brown slightly scaly patches with sharp borders. The patches occur in moist areas such as the groin, armpit, and skin folds. They may itch slightly and often look like patches associated with other fungal infections, such as ringworm.

Erythrasmic patches are typically found in intertriginous areas (skin fold areas – e.g. armpit, groin, under breast) – with the toe web-spaces being most commonly involved.

The patient is commonly otherwise asymptomatic.

Causes:
Erythrasma is caused by the bacteria Corynebacterium minutissimum.

Erythrasma is more common in warm climates. You are more likely to develop this condition if you are overweight or have diabetes.

The patches of erythrasma are initially pink, but progress quickly to become brown and scaly (as skin starts to shed).

Diagnosis:
At times, your doctor can diagnose erythrasma based on its typical appearance. But more often, your doctor will need to perform other tests to help make the diagnosis. The best way for your doctor to tell the difference between erythrasma and a fungal infection is to do a Wood’s Lamp examination on the rash. Under the UV light of a Woods Lamp, erythrasma turns a bright coral red, but fungal infections do not.

Other tests that may help include:
*A simple side-room investigation with a Wood’s lamp:It is additionally useful in diagnosing erythrasma. The ultraviolet light of a Wood’s lamp causes the organism to fluoresce a coral red color, differentiating it from fungal infections and other skin conditions.

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•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:
Since this is a bacterial infection, erythrasma is best treated with antibiotics, and fortunately several antibiotics fit the bill.

The following are antibiotics that are typically prescribed for erythrasma:
•Erythromycin 250mg four times a day for 5 days
•Clarithromycin 1gm once
•The antifungal creams miconazole, clotrimazole and econazole, but not ketoconazole
•Topical antibiotics like clindamycin or erythromycin twice a day for 2 weeks

Gently scrubbing the skin patches with antibacterial soap may help them go away.

Prognosis:
Complete recovery is expected following treatment.

Prevention:
These measures may reduce the risk of erythrasma:

•Maintaining good hygiene
•Keeping the skin dry
•Wearing clean, absorbent clothing
•Avoiding excessive heat or moisture
•Maintaining healthy body weight

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/erythrasma1.shtml
http://en.wikipedia.org/wiki/Erythrasma
http://www.nlm.nih.gov/medlineplus/ency/article/001470.htm
http://dermatology.about.com/od/infectionbacteria/a/erythrasma.htm

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