(See also Overview of Bacterial Skin Infections Overview of Bacterial Skin Infections Bacterial skin infections can be classified as skin and soft tissue infections (SSTI) and acute bacterial skin and skin structure infections (ABSSSI). SSTI include Carbuncles Ecthyma Erythrasma... read more .)
Erythrasma resembles tinea or intertrigo. It most commonly affects the foot, where it manifests as superficial scaling, fissuring, and maceration typically confined to the 3rd and 4th web spaces. Erythrasma in the groin manifests as irregular but sharply marginated pink or brown patches with fine scaling. Erythrasma may also involve the axillae, submammary or abdominal folds, and perineum, particularly in obese middle-aged women and in patients with diabetes.
Erythrasma fluoresces a characteristic coral-red color under a Wood light due to production of porphyrin by the causative bacterium. Absence of hyphae in skin scrapings also distinguishes erythrasma from tinea.
Differential diagnosis of erythrasma includes perianal streptococcal cellulitis. Perianal streptococcal cellulitis causes pain and bright-red erythema solely on perianal skin and lacks fluorescence on Wood light examination. Cultures for group A streptococcus done on skin swabs from affected children are positive. Oral therapy that targets streptococcus is typically necessary to treat perianal streptococcal infection.
Treatment
Oral clarithromycin
Topical antibiotics
Treatment of erythrasma is a single dose of oral clarithromycin 1 g. Topical erythromycin, clindamycin, 2% mupirocin, fusidic acid, and benzoyl peroxide are also effective. Topical antiseptics containing chlorhexidine or benzalkonium chloride have been shown to be effective against Corynebacterium in vitro and might help patients with erythrasma.
One to two treatments (80 J/cm2) of broadband red light (635 nm) have been successful in a small case series. Recurrence is common.
If Wood light and potassium hydroxide (KOH) or fungal culture are not available to distinguish between erythrasma and superficial fungal infection, a combination of antibacterial and antifungal topical preparations should be considered.
Drugs Mentioned In This Article
| Drug Name | Select Trade |
|---|---|
clarithromycin |
Biaxin, Biaxin XL |
benzoyl peroxide |
Acne Medication, Acne-10, Acneclear, Benprox , Benzac AC, Benzac W, Benzac-10, Benzac-5, Benzagel, Benzagel-10 , Benzagel-5, BenzaShave, BenzEFoam, BenzEFoam Ultra , BenzePrO, Benziq, Benziq LS, BP Cleanser, BP Cleansing Lotion, BP Foaming Wash, BP Gel, BP Topical , BP Wash, BP Wash Kit, BPO, BPO Creamy Wash, BPO Foaming Cloth, Brevoxyl-4, Brevoxyl-8, Clean&Clear Persa-Gel, Clearplex , Clearplex X, Clearskin, Clinac BPO, Del Aqua, Delos, Desquam-E, Desquam-X, EFFACLAR, Enzoclear, EPSOLAY, Ethexderm BPW, Inova Easy Pad, Lavoclen-4 , Lavoclen-8, NeoBenz Micro, NeoBenz Micro Cream Plus Pack, NeoBenz Micro SD, NeoBenz Micro Wash Plus Pack, Neutrogena Acne Cream, OC8, Oscion, Pacnex, Pacnex HP, Pacnex LP, Pacnex MX, PanOxyl, PanOxyl 10 Maximum Strength, PanOxyl 5, PanOxyl AQ, PanOxyl Aqua, PanOxyl-10, PanOxyl-5, PanOxyl-8, Peroderm, RE Benzoyl Peroxide , Riax, SE BPO, Seba, Seba-Gel, Soluclenz Rx , Theroxide, TL BPO MX, Triaz, Zaclir, Zoderm Cleanser , Zoderm Cream, Zoderm Gel, Zoderm Redi-Pads , Zoderm Wash |
chlorhexidine |
Betasept, Chlorostat, Hibiclens, Oro Clense , Peridex, Periogard, PerioRx , Perisol |
benzalkonium chloride |
Bactine, Care Touch, Ionax, Kid's Antiseptic Cleansing, Neosporin Wound Cleanser, Pronto Plus, RevitaDERM, Zephiran |
