Overview
Erythrasma is a bacterial skin infection caused by the bacteria Corynebacterium minutissimum.
It is more common in warm, humid environments and can occur in people of all ages, but it is more common in adults. Treatment with topical or oral antibiotics and good hygiene practices can help prevent the infection from spreading or recurring.
This blog discusses the details of the diagnosis, symptoms, treatments and prevention of Erythrasma.
What Is Erythrasma?
It is a characteristic rash that typically occurs in skin folds such as the groin, armpits, and between the toes. The rash is usually reddish-brown and can appear scaly under a UV lamp. It is not typically painful or itchy, but it can be uncomfortable. The Spread of Infection is through skin-to-skin contact, which is more common in warm and humid climates. It can also occur in people who sweat excessively or have poor hygiene practices.
Types of Erythrasma
There is only one type of erythrasma, which is caused by the bacteria Corynebacterium minutissimum. However, erythrasma can present in a different location on the body where it appears. The classification, according to the site, into different types of erythrasma include:
Intertriginous erythrasma:
This is the most common type of erythrasma and affects the skin folds, such as the groin, armpits and under the breasts.
Interdigit erythrasma:
Erythrasma toes are more common in people who wear closed-toe shoes for extended periods.
Facial erythrasma:
This type affects the face and can present as red, scaly patches on the nose and cheeks.
Generalized erythrasma:
This type of erythrasma affects multiple body areas and can indicate an underlying health condition, including diabetes.
Regardless of the type, erythrasma is a bacterial infection that requires prompt treatment to prevent the spread of the condition and minimize the risk of complications.
What Causes Erythrasma?
Though the cause of this condition is the single bacteria involved, many factors can support the development of the disease. The causative factors for Erythrasma include:
Bacterial infection:
Erythrasma is caused by Corynebacterium minutissimum, which can infect the skin and cause a red, scaly rash.
Warm and humid environments:
Erythrasma is more common in warm, moist environments, as the bacteria thrive in these conditions.
Poor hygiene:
Poor personal hygiene can increase the risk of developing Erythrasma, as it can accumulate bacteria on the skin.
Sweating:
Excessive sweating can also increase the risk of developing Erythrasma, creating a moist environment conducive to bacterial growth.
Obesity:
Obesity is a risk factor for Erythrasma, as it can lead to skin folds and increased sweating.
Diabetes:
People with high sugar levels are more prone to developing Erythrasma, as high blood sugar levels can create an environment conducive to bacterial growth.
Weakened immune system:
It increases the risk of developing Erythrasma, making it more difficult for the body to fight off bacterial infections.
What are the Symptoms of Erythrasma?
The symptoms of Erythrasma may sometimes be mistaken for other skin conditions such as ringworm, eczema, or psoriasis. Some of the distinctive features are listed below.
Red, scaly rash:
Erythrasma typically presents as a red, scaly rash usually found in skin folds, such as the groin, armpits, or between the toes.
Itching:
The affected area may be itchy or uncomfortable.
Brownish-red patches:
In some cases, the rash may be brownish-red, especially in people with darker skin tones.
Sharp borders:
The rash may have sharp borders and may be well-defined.
No blisters or pus:
Erythrasma does not typically produce blisters or pus.
May be asymptomatic:
In some cases, Erythrasma may not cause noticeable symptoms, but the bacteria can still be present on the skin.
How to Diagnose Erythrasma?
Diagnosis of Erythrasma is typically through a history, physical exam and evaluation of the symptoms.
Medical history questions
When evaluating a patient with suspected erythrasma, questions about the patient’s medical history to help make a diagnosis and develop a treatment plan are asked. Here are some medical history questions that may be asked:
- What symptoms are you experiencing? The appearance of a rash, itching, burning, or discomfort.
- How long have you had the symptoms? The duration of the rash may be necessary for helping to determine a diagnosis.
- Have you had this type of rash before? If so, when and how was it treated?
- Do you have any underlying medical conditions? Certain medical conditions, such as diabetes, may increase the risk of developing erythrasma.
- Are you taking any medications? Certain medications may increase the risk of developing erythrasma or affect the treatment of the infection.
- Do you have a history of skin infections or conditions? A history of skin infections may increase the risk of developing erythrasma.
- Have you travelled recently? Certain infections may be more common in specific geographic regions.
- Have you had any recent changes in your hygiene routine or clothing? Poor hygiene or wearing tight-fitting clothing may increase the risk of developing erythrasma.
- Do you have any allergies or sensitivities to medications or topical agents? This information is essential in determining the most appropriate treatment for the patient.
Physical examination of Erythrasma
Your doctor will examine the affected area, looking for the characteristic red, scaly rash with sharp borders. They may also use a Wood’s lamp, which emits a particular type of ultraviolet light that can make the rash glow a coral red, a classic sign of Erythrasma.
Skin Scrapping
Sometimes, a skin scraping or swab may be done to test for Corynebacterium minutissimum, which causes Erythrasma. This test can help confirm the diagnosis and ensure that another skin condition, such as ringworm or eczema, does not cause the symptoms.
Biopsy
In case of doubt about the diagnosis, performing a skin biopsy (taking a small sample of the affected skin and examining it under a microscope) is standard procedure. A biopsy can help rule out other skin conditions and confirm the presence of Erythrasma.
How do You Treat Erythrasma?
Treatment of erythrasma typically involves topical or oral antibiotics. Here are some standard treatment options:
Topical Antibiotics:
The first-line treatment for erythrasma is usually topical antibiotics, such as clindamycin, erythromycin, or miconazole cream. Applying these directly to the affected area and are typically used for a few weeks until the infection clears up.
Oral Antibiotics:
For more severe cases of erythrasma, oral antibiotics may be necessary. The doctor may prescribe antibiotics such as erythromycin, azithromycin, or tetracycline. These antibiotics are usually taken for several weeks until the infection clears up.
Photodynamic Therapy:
Patients with erythrasma may receive treatment with photodynamic therapy utilizing red light (broadband, peaking at 635 nm).
Maintaining Good Hygiene:
To prevent erythrasma from spreading, it is crucial to maintain good hygiene practices, such as showering regularly, keeping the affected area clean and dry, and avoiding tight-fitting clothing.
Complications in Erythrasma
Erythrasma typically go away on its own. Contact dermatitis, lichenification and coinfection with various bacteria, yeasts, and dermatophytes can make it more challenging.
While serious complications of erythrasma are rare, there are reports of more severe infections caused by Corynebacterium minutissimum. Here are some possible complications associated with erythrasma:
Abscess:
In rare cases, erythrasma can lead to an abscess, a pocket of pus that forms under the skin. This can be a painful and potentially serious complication.
Cellulitis:
Erythrasma can lead to cellulitis, an infection of the deep layers of the skin. Cellulitis can cause redness, swelling, pain, and warmth in the affected area and may require antibiotic treatment.
Cutaneous granuloma:
In rare cases, erythrasma can lead to the formation of a cutaneous granuloma, which is a type of skin lesion by the body’s immune response to an infection. Granulomas can be firm and raised and may have a reddish or purplish appearance.
Endocarditis:
Although rare, erythrasma can cause an infection of the heart valves. Endocarditis can be a severe and potentially life-threatening condition that requires prompt medical attention.
Pyelonephritis:
Erythrasma can also lead to pyelonephritis, a bacterial infection of the kidneys. Symptoms of pyelonephritis can include fever, chills, back pain, and vomiting and may require antibiotic treatment.
Endophthalmitis:
Endophthalmitis is a rare but potentially severe complication of erythrasma. It occurs when the infection spreads to the eye and can lead to vision loss or even blindness.
Arteriovenous fistula infection:
Erythrasma can lead to infection of an arteriovenous fistula, which is a surgical connection in an artery and a vein in dialysis patients. This can lead to complications and may require additional medical intervention.
Meningitis:
While rare, meningitis, an inflammation of the membranes surrounding the brain and spinal cord is a complication of erythrasma. Meningitis can be a severe and potentially life-threatening condition that requires prompt medical attention.
While these complications are rare, seeking medical attention is essential if you suspect you have erythrasma or are experiencing skin changes or symptoms. Early diagnosis and treatment can help prevent the development of more severe complications.
Erythrasma Prevention
Prevention of Erythrasma includes the following steps:
Maintain good hygiene:
Shower regularly, and use soap and water to clean your skin thoroughly. Dry your skin well after showering, paying particular attention to skin folds like the groin, armpits, and under the breasts.
Wear clean clothes:
Change your clothes daily, especially if you sweat a lot. Make sure your clothes are clean and dry before wearing them.
Avoid tight-fitting clothes:
Tight-fitting clothes can trap moisture, creating a favorable environment for bacterial growth. Wear loose-fitting clothing made of breathable materials, such as cotton.
Keep skin folds dry:
Use talcum powder to dry skin folds, particularly in areas prone to moisture, such as the groin, armpits, and under the breasts.
Manage underlying medical conditions:
If you have an underlying medical condition, such as diabetes, work with your healthcare provider to manage your condition and prevent complications.
Avoid sharing personal items:
Do not share towels, clothing, or personal items with others, as this can increase the risk of bacterial transmission.
Treat any skin infections promptly:
If you notice any signs of a skin infection, such as redness, itching, or rash, seek medical attention to prevent the disease from spreading or worsening.
FAQs about Erythrasma Answered by Your Doctors Online Team
How does someone get erythrasma?
The exact way someone gets erythrasma is not entirely understood. The bacteria may spread through close skin-to-skin contact or by sharing towels, clothing, or bedding with someone infected.
Certain factors can increase the risk of erythrasma, including obesity, diabetes, and a weakened immune system. People who sweat excessively, especially in warm or humid conditions, are also at greater risk.
Good hygiene practices, such as keeping the affected areas clean and dry, can help prevent the spread of erythrasma. It is also important to avoid sharing towels, clothing, or bedding with someone infected.
Can erythrasma go away on its own?
Erythrasma is a bacterial skin infection that usually does not go away. Without proper treatment, the condition can persist and even spread to other areas of the body.
How long does erythrasma take to go away?
The duration of erythrasma can vary depending on the severity of the infection, the area of the body affected, and the type of treatment used. With appropriate treatment, erythrasma usually clears up within a few weeks.
