Erythrasma

Dermatology

Clinicals - History

Fact Explanation
Dark discoloration of body folds including inner thighs, toe web spaces, axillae, submammary areas, etc (regions rich in heat and humidity). Corynebacterium minutissimum, is usually present as a normal human skin inhabitant, when it invades the stratum corneum (upper 1/3) under favorable conditions of heat and humidity, the organism proliferate, which promotes formation of a hyperkeratotic stratum corneum . Dark discoloration of body folds including inner thighs, toe web spaces, axillae, submammary areas, etc (regions rich in heat and humidity).
Corynebacterium minutissimum, is usually present as a normal human skin inhabitant, when it invades the stratum corneum (upper 1/3) under favorable conditions of heat and humidity, the organism proliferate, which promotes formation of a hyperkeratotic stratum corneum .
Pruritus of the affected regions. Due to thickening of the stratum corneum as a result of the infection . Pruritus of the affected regions.
Due to thickening of the stratum corneum as a result of the infection .
History of excessive sweating associated with a warm climate. Increased humidity favors the growth of the causative organism . History of excessive sweating associated with a warm climate.
Increased humidity favors the growth of the causative organism .
History of diabetes mellitus. The immunocompromised state in diabetes promotes the occurrence of opportunistic infection . History of diabetes mellitus.
The immunocompromised state in diabetes promotes the occurrence of opportunistic infection .

Clinicals - Examination

Fact Explanation
Well-demarcated, brown-red macular patches in the affected regions of skin. The skin also presents with fine scales. These changes occur as a result of lichenification of the affected areas of skin secondary to the thickened stratum corneum and associated pruritus . Well-demarcated, brown-red macular patches in the affected regions of skin. The skin also presents with fine scales.
These changes occur as a result of lichenification of the affected areas of skin secondary to the thickened stratum corneum and associated pruritus .

Investigations - Diagnosis

Fact Explanation
Wood's light examination of erythrasma lesions revealing coral-red fluorescence of lesions. Excess Copro III synthesis by Corynebacterium leads to accumulation of porphyrin in cutaneous tissue, which fluoresces a coral-red colour when exposed to Wood’s light . Wood's light examination of erythrasma lesions revealing coral-red fluorescence of lesions.
Excess Copro III synthesis by Corynebacterium leads to accumulation of porphyrin in cutaneous tissue, which fluoresces a coral-red colour when exposed to Wood’s light .
Microscopic examination of scales using the Methylene blue stain, which is used to highlight both the fungal spores of pityriasis versicolor and the curved or club-shaped bacterial rods of C. minutissimum. This can be used as a single method to diagnose both conditions at the same time . It should be noted that these 2 diseases can co exist. Microscopic examination of scales using the Methylene blue stain, which is used to highlight both the fungal spores of pityriasis versicolor and the curved or club-shaped bacterial rods of C. minutissimum.
This can be used as a single method to diagnose both conditions at the same time . It should be noted that these 2 diseases can co exist.

Investigations - Management

Fact Explanation
Fasting blood glucose levels. The immunocompromised state in diabetes promotes the occurrence of opportunistic infection . Fasting blood glucose levels.
The immunocompromised state in diabetes promotes the occurrence of opportunistic infection .

Management - Supportive

Fact Explanation
Educate on personal hygiene. Personal cleanliness produces a significant reduction in the carriage of diphtheroids in the skin . Educate on personal hygiene.
Personal cleanliness produces a significant reduction in the carriage of diphtheroids in the skin .

Management - Specific

Fact Explanation
Erythromycin. Dose: 250 mg 4 times a day for 14 days given orally. Inhibits bacterial growth by inducing dissociation of peptidyl t-RNA from ribosomes, resulting in RNA-dependent protein synthesis to come to a halt . C. minutissimum shows increased susceptibility to the drug. Erythromycin. Dose: 250 mg 4 times a day for 14 days given orally.
Inhibits bacterial growth by inducing dissociation of peptidyl t-RNA from ribosomes, resulting in RNA-dependent protein synthesis to come to a halt . C. minutissimum shows increased susceptibility to the drug.
Illumination of lesions (80 J/cm2) by red light (broad band, peak at 635 nm). It utilizes reactive oxygen species produced by a non-toxic dye or photosensitizer molecule in the presence of low intensity visible light to kill microbial cells . Illumination of lesions (80 J/cm2) by red light (broad band, peak at 635 nm).
It utilizes reactive oxygen species produced by a non-toxic dye or photosensitizer molecule in the presence of low intensity visible light to kill microbial cells .

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