Erythrasma

Author: Reviewed and updated by Dr Amanda Oakley Dermatologist, Hamilton, New Zealand; and Vanessa Ngan, Staff Writer; June 2014, and by Dr Jannet Gomez, Postgraduate student in Clinical Dermatology, Queen Mary University London, UK, in July 2016.

What is erythrasma?

Erythrasma is a common skin condition affecting the skin folds such as under the arms, in the groin and between the toes.

Who gets erythrasma?

Erythrasma affects males and females, but it is thought to be more common in the groin of males and between the toes of females.

It is reported to be more prevalent in the following circumstances: 

What causes erythrasma?

The bacteria responsible for erythrasma are gram-positive, non-spore-forming, aerobic or facultative bacilli called Corynebacterium minutissimum

Erythrasma may coexist with or be confused with other causes of intertrigo (rashes in the skin folds) including fungal infections such as tinea or Candida albicans (thrush). 

What are the clinical features of erythrasma?

Erythrasma presents as well-defined pink or brown patches with fine scaling and superficial fissures. Mild itching may be present.

Common sites for erythrasma are armpits, groin and between the toes. Intergluteal fold, submammary, and periumbilical skin may also be affected. Widespread infections are associated with diabetes mellitus.

Erythrasma is classified into 3 types according to location.

  1. Interdigital erythrasma: between 3rd, 4th and 5th toe web spaces
  2. Intertriginous erythrasma: in armpits, groin, under the breasts and umbilicus
  3. Generalised/disciform erythrasma: on the trunk 

More images of erythrasma ...

What are the complications of erythrasma?

Erythrasma is usually self limiting. It can be complicated by contact dermatitis, lichenification, postinflammatory pigmentation, and coinfection with other bacteria, yeasts, and dermatophytes.

Serious complications are very rare. Corynebacteria have been reported to causes abscess, cellulitis,  cutaneous granuloma, endocarditis, pyelonephritis, endophthalmitis,  arteriovenous fistula infection and meningitis.

How is the diagnosis of erythrasma made?

Erythrasma has a typical clinical appearance. Diagnosis may be supported by the following investigations.

What is the treatment for erythrasma?

Erythrasma can be treated with antiseptic or topical antibiotic such as:

Extensive infection can be treated with oral antibiotics, including erythromycin or tetracycline and usually responds promptly. 

Photodynamic therapy using red light (broadband, peak at 635 nm) has also been used to treat patients with erythrasma.

Prevention of erythrasma

Recurrence of erythrasma is common. Antibacterial soap can be used to prevent recurrence. Treatment can be repeated if necessary.

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