Erythrasma Clinical Presentation

  • Author: Abdul-Ghani Kibbi, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 7, 2012
 

History

Dark discoloration associated with erythrasma is usually limited to body folds that are naturally moist and occluded. Infection commonly is asymptomatic, but it can be pruritic. The duration of erythrasma ranges from months to years. Widespread involvement of trunk and limbs is possible.

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Physical

The typical appearance of erythrasma is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scales (see the image below).

Lichenification and hyperpigmentation are common. Lichenification and hyperpigmentation are common. The skin occasionally has a wrinkled appearance with scales. KOH test results are negative. Courtesy of Michael Bryan, MD.

Infection commonly is located over inner thighs, crural region, scrotum, and toe webs. Axillae, submammary area, periumbilical region, and intergluteal fold are less commonly involved in erythrasma. Toe web lesions appear as maceration, with the fourth interdigital space most frequently affected.[15]

Due to the association of erythrasma with other corynebacterial skin infections such as pitted keratolysis and trichomycosis axillaris, all body folds and feet should be screened.{{Ref16}

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Causes

C minutissimum, a member of the normal skin flora, is the causative agent of erythrasma. The bacterium is a lipophilic, gram-positive, non–spore-forming, aerobic, and catalase-positive diphtheroid. C minutissimum ferments glucose, dextrose, sucrose, maltose, and mannitol.

Predisposing factors for erythrasma include the following:

  • Excessive sweating/hyperhidrosis
  • Delicate cutaneous barrier
  • Obesity
  • Diabetes mellitus
  • Warm climate
  • Poor hygiene
  • Advanced age
  • Other immunocompromised states
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Contributor Information and Disclosures
Author

Abdul-Ghani Kibbi, MD  Professor and Chair, Department of Dermatology, American University of Beirut Medical Center, Lebanon

Disclosure: Nothing to disclose.

Coauthor(s)

Ruba Faik Bahhady, MD  Senior Specialist, Department of Dermatology, American University of Beirut Medical Center

Disclosure: Nothing to disclose.

Zenus Saleh, MD  Staff Physician, Department of Dermatology, American University of Beirut Medical Center

Zenus Saleh, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Fady G Haddad, MD  Consulting Staff, Division of Dermatology, American University of Beirut Medical Center, Dubai Healthcare City

Fady G Haddad, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Robin Travers, MD  Assistant Professor of Medicine (Dermatology), Dartmouth University School of Medicine; Staff Dermatologist, New England Baptist Hospital; Private Practice, SkinCare Physicians

Robin Travers, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Informatics Association, Massachusetts Medical Society, Medical Dermatology Society, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Dellion S, Morel P, Vignon-Pennamen D, Felten A. Erythrasma owing to an unusual pathogen. Arch Dermatol. Jun 1996;132(6):716-7. [Medline].

  2. Sarkany I, Taplin D, Blank H. Incidence and bacteriology of erythrasma. Arch Dermatol. May 1962;85:578-82. [Medline].

  3. Inci M, Serarslan G, Ozer B, et al. The prevalence of interdigital erythrasma in southern region of Turkey. J Eur Acad Dermatol Venereol. Oct 7 2011;[Medline].

  4. Bandera A, Gori A, Rossi MC, et al. A case of costochondral abscess due to Corynebacterium minutissimum in an HIV-infected patient. J Infect. Jul 2000;41(1):103-5. [Medline].

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  16. Aste N, Pau M, Aste N. Pityriasis versicolor on the groin mimicking erythrasma. Mycoses. Jun 2004;47(5-6):249-51. [Medline].

  17. Karakatsanis G, Vakirlis E, Kastoridou C, Devliotou-Panagiotidou D. Coexistence of pityriasis versicolor and erythrasma. Mycoses. Aug 2004;47(7):343-5. [Medline].

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  26. Clayton YM, Connor BL. Comparison of clotrimazole cream, Whitfield's ointment and Nystatin ointment for the topical treatment of ringworm infections, pityriasis versicolor, erythrasma and candidiasis. Br J Dermatol. Sep 1973;89(3):297-303. [Medline].

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Lichenification and hyperpigmentation are common. The skin occasionally has a wrinkled appearance with scales. KOH test results are negative. Courtesy of Michael Bryan, MD.
Under Wood lamp examination, the porphyrins produced by the bacteria fluoresce with a coral pink color. A small focus is visible on this photo. If the patient recently has bathed, the pigment may be washed away. In suspicious cases, a repeat examination the following day may be necessary. Courtesy of Michael Bryan, MD.
 
 
 
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