Erythrasma : What Is It ? Treatment and Advice For Patient
Erythrasma is a chronic superficial infection of the intertriginous areas of the skin. It is caused by over growth of Corynebacterium minutissimum, which usually is present as a normal flora of the skin.
A warm, humid climate, obesity and Diabetes is a predisposing factor. It is commonly seen among adults.
Among normal populations, mild toe-cleft scaling maceration is common. Clinically manifest with pink, brawn scaly macules or macerated white areas. It occurs most commonly in the groins, axillae and the intergluteal and submammary flexures, or between the toes.
In the groins, it affects the area of one or both thighs in contact with the scrotum. Dark faintly scaly patch on both sides of inner thigh with ill defined margins.
Differential diagnosis (DDx):
• Pityriasis versicolor
On the thighs, groins and pubic area, Tinea cruris may be simulated, but the relative lack of inflammation, complete absence of vesiculation and absence of satellite lesions point against Tinea.
It is difficult to differentiate erythrasma of the toe clefts from Tinea pedis or Candida infection.
Since most patients have both Candida and erythrasma, it may worsen if only one condition is treated.
Treatment
Erythrasma responds well to most topically applied azole antifungal agents, such as 1%clotrimazole and 2% miconazole. The duration of therapy varies, but 2 weeks is usually sufficient for topical fucidin and erythromycin.
Oral erythromycin and tetracycline can also be used. Relapse is a problem in some patients. In these cases, the usual approach adopted is to give long-term antiseptic soaps, such as povidone-iodine and to use drying agents, such as powders, in the affected areas.
Advise the patient to take frequent bath.
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