Excerpt from Erythrasma

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Background

Erythrasma is a chronic superficial infection of the intertriginous areas of the skin. The incriminated organism is Corynebacterium minutissimum, which usually is present as a normal human skin inhabitant. In 1996, Corynebacterium afermentans was reported in one case.

Pathophysiology

Corynebacteria invade the upper one-third of the stratum corneum; under favorable conditions such as heat and humidity, these organisms proliferate. The stratum corneum is thickened. The organisms are seen in the intercellular spaces as well as within cells, dissolving keratin fibrils. The coral red fluorescence of scales seen under Wood light is secondary to the production of porphyrin by these diphtheroids.

Frequency

International

The incidence of erythrasma is reported to be around 4%. This infection is observed all over the world; the widespread form is found more frequently in the subtropical and tropical areas than in other parts of the world.

Mortality/Morbidity

Erythrasma is usually a benign condition. However, it may become widespread and invasive in predisposed and immunocompromised individuals; this is very rare in immunocompetent hosts. In such individuals, this organism has caused infections other than erythrasma. These include abscess formation (3 cases), intravascular catheter–related infections (3 cases), primary bacteremia (3 cases), peritoneal catheter–related infections (2 cases), endocarditis (1 case), and pyelonephritis (1 case).

Race

The incidence is higher in black people.

Sex

Both sexes are equally affected; however, the crural form is more common in men.

Age

The incidence of erythrasma increases with age, but no age group is immune to the disease. The youngest patient reported to have this condition is a 1-year-old infant.

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