What are the other Names for this Condition? (Also known as/Synonyms)

• Skin Infection due to Corynebacterium Minutissimum

What is Erythrasma? (Definition/Background Information)

• Erythrasma is a superficial skin infection caused by the bacterium Corynebacterium minutissimum. It is a common condition that more commonly affects the elderly adults, resulting in light to dark tan scaly skin patches
• There are three forms of Erythrasma that are classified based on the body region affected. These include:
  • Interdigital Erythrasma - as the name indicates, it infects the skin between the toes
  • Intertriginous Erythrasma - it involves the skin folds in the armpits, beneath the breasts, and groin region
  • Generalized/Disciform Erythrasma - occur in other parts of the body such as the trunk, limbs, and feet
• The signs and symptoms of Erythrasma includes the presence of numerous skin lesions that may present itching or burning sensation. In most cases, complications are uncommon, but may include cosmetic issues and development of opportunistic infections
• The treatment for Erythrasma may involve the use of antibacterial soaps and creams, antibiotics, and photodynamic therapy, if needed. The prognosis is typically good with adequate treatment, but the condition is often known to recur

Who gets Erythrasma? (Age and Sex Distribution)

• The incidence of Erythrasma is around 4% among the general population; it is a common chronic condition
• The skin condition is observed in individuals of all ages; both children and adults are affected. However, it is more common in elderly adults, and less common in children
• Both males and females are affected; some medical literature informs that a preference for males is noted
• Individuals of all racial and ethnic groups may be affected. A greater number of cases are noted in Asians, Africans, and African Americans
• Erythrasma is more common in the tropical and sub-tropical areas of the world

What are the Risk Factors for Erythrasma? (Predisposing Factors)

The following are some known risk factors for Erythrasma:

• Advancing age: The incidence of Erythrasma is higher in older adults
• Individuals with weakened immune systems
• Poor body hygiene
• Increased sweating (hyperhidrosis) - there is an increased risk for athletes and sportspersons
• Tight clothing that makes sweating difficult
• Type 2 diabetes
• Obesity
• Warm geographical climates
• Dark-skinned individuals have a higher risk for Erythrasma development

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Erythrasma? (Etiology)

Erythrasma is a bacterial skin infection caused by the low grade pathogen Corynebacterium minutissimum.

What are the Signs and Symptoms of Erythrasma?

The signs and symptoms of Erythrasma may vary among the affected individuals. It may be mild or severe. It also depends on the type of Erythrasma, whether generalized, interdigital, or intertriginous. However, in many individuals, it does not cause any significant signs and symptoms.

The common signs and symptoms include:

• Multiple skin lesions that become dark and scaly with time
• It can be seen in the groin, armpits, under the breasts, and other areas where skin folds are present
• Other frequently affected areas include the legs and thighs
• A distinguishing feature from tinea (fungus or ringworm) infections, is that Erythrasma has patches without clearing of the central area, and no active scaly margin. These are typical features of tinea
• The skin lesions are usually well-defined and mild itching may be present
• Mild burning sensation may be noted
• Infection of groin area is more common in men than women
• The most commonly infected areas are the toes, especially the 4th and 5th toes
• Cracking of the soles may be noted

How is Erythrasma Diagnosed?

The following tests and procedures may be performed to diagnose Erythrasma:

• Complete physical examination and a thorough medical history evaluation
• Complete blood count (CBC), antibody test, and tissue culture studies, as necessary
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. In Erythrasma, pigments in the bacteria will glow coral pink under the Wood’s lamp. The finding will not always be present if the area has been recently washed
• Skin biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis to eliminate other conditions may be considered, before arriving at a definitive diagnosis. These conditions include:

• Allergic contact dermatitis
• Bacterial skin infections
• Intertrigo
• Psoriasis
• Seborrheic dermatitis
• Skin fungus or yeast infections

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Erythrasma?

Complications in Erythrasma are rare, but may include the following:

• Development of secondary infections such as cellulitis
• Cosmetic concerns
• Abscess formation
• The skin can get permanently hyperpigmented (post-infectious hyperpigmentation)
• Extremely rarely, Corynebacterium minutissimum can cause system infection affecting some of the vital organs in the body (such as the heart, kidney, eye, and brain)
• Recurrences are commonly noted

How is Erythrasma Treated?

Erythrasma is managed in the following manner:

• In case of minor signs and symptoms, cleaning the area using antibacterial soap may be considered. If it does not resolve, then antibacterial creams may be used
• For severe cases, antibiotics may be administered
• Photodynamic therapy
• In some individuals, it may be persistent and difficult to treat. In such cases, one should be screened for diabetes
• Weight loss if one is obese or overweight

How can Erythrasma be Prevented?

The preventative measures for Erythrasma may include:

• Avoid tight-fitting clothing
• Maintain clean habits, wash hands frequently, and take care of personal hygiene
• Avoid scratching the skin lesions which may increase the risk for secondary infections and exacerbate the condition
• Control diabetes
• Losing weight if one is obese or overweight
• Treat any underlying causative conditions that may increase the risk for Erythrasma

What is the Prognosis of Erythrasma? (Outcomes/Resolutions)

• The prognosis of Erythrasma depends on the type of infection (generalized, interdigital, or intertriginous), severity of the signs and symptoms, and overall health status of the individual
• In a majority of cases, the prognosis is good with adequate treatment, since Erythrasma is a non-life-threatening infection. However, recurrences are commonly noted

Additional and Relevant Useful Information for Erythrasma:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/