Erythrasma is a pseudomycosis of a chronic nature and bacterial origin, which affects the epidermis mainly in the places of skin folds. This disease is characterized by the appearance and fusion of painless spots of brown-red, gray-brown or yellow-brown color, which are covered with small flaky scales. Erythrasma is diagnosed based on the localization of foci and the development of its clinical picture. The typical luminescence of a fluorescent lamp and the microscopic pattern characteristic of erythrasma also helps to determine this disease. Disinfection of clothes and bed linen plays an important role during the treatment of erythrasma. Additionally, the affected areas are treated, antibiotic treatment, ultraviolet irradiation, and regulation of blood sugar levels are carried out.
The content of the article:
What is erythrasma
Erythrasma in diabetes mellitus
Causes of erythrasma
Symptoms of erythrasma
Diagnosis of erythrasma
Treatment of erythrasma
Prevention of erythrasma
Erythrasma
What is erythrasma
Erythrasma is so called due to the fact that when using luminescent diagnostics, the foci glow with a reddish hue. This disease occurs most often in adults, mainly among male patients and proceeds for a very long time. At the same time, the patient does not experience any negative and painful sensations.
For a long period of time, erythrasma, together with actinomycosis, trichophytia, pityriasis, microsporia, favus and epidermophytia, was considered a skin disease of fungal etiology for the reason that during microscopic analysis of scales that were removed from the affected skin foci, it was possible to detect sinuous thin filaments that superficially resemble fungal mycelia. In the current classification, dermatologists believe that erythrasma belongs to the group of pseudomycoses. These diseases are very similar in their clinical picture to a skin lesion by a fungus, but they have a completely different etiology.
Erythrasma in diabetes mellitus
In the treatment of erythrasma in people suffering from diabetes mellitus, it is necessary to consult an endocrinologist in order to correctly adjust the blood sugar level. Patients suffering from excessive sweating during erythrasma remission should be treated for hyperhidrosis in order to avoid re-infection. The methods of treatment of hyperhidrosis include: sympathectomy, curettage, ultrasound destruction or the method of surgical excision of sweat glands in the problem area.
Causes of erythrasma
The only causative agent of erythrasma is the cornobacterium Corynebacterium minutissimum. The bacterium is slightly pathogenic and has a very low contagiousness (the property of the disease to be transmitted from sick people or animals to healthy people or animals). Normally, the pathogen is often located on the skin of absolutely healthy people in the role of a saprophytic microorganism. The infection is transmitted by contact mainly through personal use items, as well as during sexual intercourse, walking barefoot on the beach or bare ground, visiting a sauna or swimming pool.
The erythrasma bacterium affects the surface layer of the skin (epidermis), while the hair and nails remain not involved in the infection process (intact). Also, the penetration of bacteria into the layers of the epidermis is facilitated by such processes as changes in the pH of the skin (in the alkaline side), hyperhidrosis, hot climate with high humidity, friction and maceration of the skin, diaper rash, insufficient skin hygiene, individual characteristics of the body.
Symptoms of erythrasma
The appearance on the surface of the skin of rounded spots of light brown, yellow-brown, brownish-red color indicates the onset of the disease. The size of the spots can be from a few millimeters to several centimeters in diameter. Spots with erythrasma mostly have round edges, but there are also scalloped (wavy) edges.
With an increase in size, the lesions of erythrasma begin to merge, while forming one single lesion site that is clearly delimited from healthy skin. This area has a smooth, even surface and is covered with small bran-like scales on top. After a while, in the central part of the area affected by erythrasma, you can notice brown staining or even paling of color.
Erythrasma is characteristically localized around and inside large skin folds. In males, the most common lesion is observed in the groin area, the skin around the anus, and the inner surface of the thighs. In the female, erythrasma most often occurs in the area of folds under the mammary glands, as well as on the skin in the umbilical and axillary zones. In people who are overweight, erythrasma may affect the fat folds on the abdomen.
Most often, erythrasma is not associated with any subjective unpleasant sensations. Occasionally, the patient may notice a slight itching or burning sensation. For this reason, erythrasma can proceed almost imperceptibly and asymptomatically for a long time. Erythrasma proceeds for quite a long time (about 10 years) and can be accompanied by frequent alternation of periods during which either remissions or exacerbations occur. Exacerbations of erythrasma most often occur during the spring-summer period, when the warm temperature contributes well to the active reproduction of bacteria. Patients with obesity, diabetes mellitus and hyperhidrosis may suffer from a complicated form of erythrasma. In this case, the symptoms of erythrasma are joined by symptoms of eczema, as well as secondary infection of the lesion with the disease or the appearance of diaper rash. The development of complications, in one form or another, is facilitated by frequent friction, wet and contaminated affected area of the skin. With complicated erythrasma, a burning and itching sensation is characteristic, as well as the appearance of pain in the affected area.
Diagnosis of erythrasma
Its typical clinical picture and typical localization of lesions, as well as red-brick or red-coral glow during a fluorescent examination using a Wood lamp, helps to diagnose the disease effectively. The luminescent examination should take place on an area of erythrasma that has not been subjected to any treatment, since washing or processing washes away the pigment secreted by bacteria. When conducting a microscopic examination of the scrape, which was taken from the area of the skin affected by the disease, it is possible to identify sinuous filaments similar to the mycelium of the fungus, as well as coccoid cells in the form of separate groups or chains.
Erythrasma has some signs of the clinical picture of diseases such as inguinal epidermophytia, multicolored lichen, candidiasis of the skin, rubromycosis, pink lichen, microbial eczema, perianal dermatitis. In special episodes, in order to distinguish erythrasma from similar diseases, bacterial culture of scraping is carried out to clearly identify the pathogen. In parallel, the sensitivity of the pathogen to antibacterial drugs is also being determined. This is primarily necessary for the correct prescription of medication for general antibiotic therapy.
Treatment of erythrasma
Local therapy of erythrasma is limited to rubbing erythromycin or sulfur-tar ointment into the affected area. This procedure is usually performed twice a day for a week. After this manipulation, the erythrasma spots slowly and gradually change their color to a paler one and eventually disappear. In the case of secondary infection, as well as when inflammatory changes appear in the lesions of erythrasma, they are treated with aniline dyes or resorcinol alcohol. Also, a large number or area of lesions is an indication for starting systemic antibiotic therapy.
The elimination of erythrasma foci and the prevention of further exacerbations of the disease is facilitated by the disinfecting and drying effect of soft ultraviolet rays. For this reason, it is very useful for patients to stay in sunlight as long as possible in the evening and in the morning, attend sessions of ultraviolet irradiation.
In order to prevent self-infection and successfully cure erythrasma, it is necessary, if possible, to carry out complete disinfection of clothes, bed linen and personal belongings of the patient. Clothes and underwear must be washed every day and be sure to iron them afterwards.
Prevention of erythrasma
First of all, prevention of erythrasma consists in observing the rules of skin hygiene, carefully wiping large folds of skin after taking water procedures, refusing tight clothes, as well as synthetic clothing. Secondary prevention involves the prevention of the development of relapses of the disease. Prevention is carried out within a month after the last symptom of the disease has disappeared. It consists in washing the skin folds with camphor or salicylic alcohol with a layer of talc.
