Erythrasma Workup

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

Laboratory Studies

Wood light examination of erythrasma lesions reveals coral-red fluorescence of lesions. Results may be negative if the patient bathed prior to presentation.[23] Note the image below. The cause of this color fluorescence has been attributed to excess coproporphyrin III synthesis by these organisms, which accumulates in cutaneous tissue and emits a coral-red fluorescence when exposed to a Wood light.[24, 24]

Under Wood lamp examination, the porphyrins producUnder 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.

Gram staining reveals of erythrasma lesions gram-positive filamentous rods. In culture media composed of 20% fetal bovine serum, 2% agar, 78% tissue culture medium #199, and 0.05% tris, the organisms grow as nonhemolytic, 1- to 1.5-mm smooth colonies. Methylene blue stain may be used to highlight both the fungal spores of pityriasis versicolor and the curved or club-shaped bacterial rods of C minutissimum, the causative agent of erythrasma, in case both organisms coexist.[18]

Next

Histologic Findings

The diphtheroid bacteria that cause erythrasma are present in the horny layer as rods and filaments.[25]

Previous
Proceed to Treatment & Management
 
 
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].

  5. Van Bosterhaut B, Cuvelier R, Serruys E, Pouthier F, Wauters G. Three cases of opportunistic infection caused by propionic acid producing Corynebacterium minutissimum. Eur J Clin Microbiol Infect Dis. Jul 1992;11(7):628-31. [Medline].

  6. Fernandez Giron F, Saavedra Martin JM, Benítez Sanchez M, Fernandez Mora F, Rodriguez Gomez E. Corynebacterium minutissimum peritonitis in a CAPD patient. Perit Dial Int. May-Jun 1998;18(3):345-6. [Medline].

  7. Aperis G, Moyssakis I. Corynebacterium minutissimum endocarditis: a case report and review. J Infect. Feb 2007;54(2):e79-81. [Medline].

  8. Herschorn BJ, Brucker AJ. Embolic retinopathy due to Corynebacterium minutissimum endocarditis. Br J Ophthalmol. Jan 1985;69(1):29-31. [Medline].

  9. Ahmad NM, Ahmad KM. Corynebacterium minutissimum pyelonephritis with associated bacteraemia: a case report and review of literature. J Infect. Dec 2005;51(5):e299-303. [Medline].

  10. Craig J, Grigor W, Doyle B, Arnold D. Pyelonephritis caused by Corynebacterium minutissimum. Pediatr Infect Dis J. Dec 1994;13(12):1151-2. [Medline].

  11. Granok AB, Benjamin P, Garrett LS. Corynebacterium minutissimum bacteremia in an immunocompetent host with cellulitis. Clin Infect Dis. Aug 15 2002;35(4):e40-2. [Medline].

  12. Arsan AK, Sizmaz S, Ozkan SB, Duman S. Corynebacterium minutissimum endophthalmitis: management with antibiotic irrigation of the capsular bag. Int Ophthalmol. 1995-1996;19(5):313-6. [Medline].

  13. Santos-Juanes J, Galache C, Martinez-Cordero A, et al. Cutaneous granulomas caused by corynebacterium minutissimum in an HIV-infected man. J Eur Acad Dermatol Venereol. Nov 2002;16(6):643-5. [Medline].

  14. Dalal A, Likhi R. Corynebacterium minutissimum bacteremia and meningitis: a case report and review of literature. J Infect. Jan 2008;56(1):77-9. [Medline].

  15. Morales-Trujillo ML, Arenas R, Arroyo S. [Interdigital erythrasma: clinical, epidemiologic, and microbiologic findings]. Actas Dermosifiliogr. Jul-Aug 2008;99(6):469-73. [Medline].

  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].

  18. Bowyer A, McColl I. Erythrasma and pruritus ani. Acta Derm Venereol. 1971;51(6):444-7. [Medline].

  19. Marinella MA. Erythrasma and seborrheic dermatitis of the groin. Am Fam Physician. Nov 15 1995;52(7):2012. [Medline].

  20. Rho NK, Kim BJ. A corynebacterial triad: Prevalence of erythrasma and trichomycosis axillaris in soldiers with pitted keratolysis. J Am Acad Dermatol. Feb 2008;58(2 Suppl):S57-8. [Medline].

  21. Finch J. Case of trichomycosis axillaris and erythrasma. J Drugs Dermatol. Dec 2011;10(12):1472-3. [Medline].

  22. Mattox TF, Rutgers J, Yoshimori RN, Bhatia NN. Nonfluorescent erythrasma of the vulva. Obstet Gynecol. May 1993;81(5 (Pt 2)):862-4. [Medline].

  23. Yasuma A, Ochiai T, Azuma M, et al. Exogenous coproporphyrin III production by Corynebacterium aurimucosum and Microbacterium oxydans in erythrasma lesions. J Med Microbiol. Jul 2011;60:1038-42. [Medline].

  24. Montes LF, Black SH, McBride ME. Bacterial invasion of the stratum corneum in erythrasma. I. Ultrastructural evidence for a keratolytic action experted by Corynebacterium minutissimum. J Invest Dermatol. Nov 1967;49(5):474-85. [Medline].

  25. Darras-Vercambre S, Carpentier O, Vincent P, Bonnevalle A, Thomas P. Photodynamic action of red light for treatment of erythrasma: preliminary results. Photodermatol Photoimmunol Photomed. Jun 2006;22(3):153-6. [Medline].

  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].

  27. Hamann K, Thorn P. Systemic or local treatment of erythrasma? A comparison between erythromycin tablets and Fucidin cream in general practice. Scand J Prim Health Care. Mar 1991;9(1):35-9. [Medline].

  28. Holdiness MR. Management of cutaneous erythrasma. Drugs. 2002;62(8):1131-41. [Medline].

  29. Wharton JR, Wilson PL, Kincannon JM. Erythrasma treated with single-dose clarithromycin. Arch Dermatol. Jun 1998;134(6):671-2. [Medline].

  30. Turk BG, Turkmen M, Aytimur D. Antibiotic susceptibility of Corynebacterium minutissimum isolated from lesions of Turkish patients with erythrasma. J Am Acad Dermatol. Dec 2011;65(6):1230-1. [Medline].

  31. Avci O, Tanyildizi T, Kusku E. A comparison between the effectiveness of erythromycin, single-dose clarithromycin and topical fusidic acid in the treatment of erythrasma. J Dermatolog Treat. Sep 18 2011;[Medline].

 
Previous
Next
 
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.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.