What is it and why does it occur?
The causative agent is Corynebacterium, a common inhabitant of the skin. In warm and moist folds, where the skin is constantly in contact with itself, the bacterium begins to actively multiply in the superficial stratum corneum. It does not penetrate deeply and does not cause severe inflammation, but it produces a pigment that gives the spots a characteristic brownish tint, and substances that glow in ultraviolet light. That is why the disease progresses sluggishly and remains undetected for a long time. Provoking conditions are heat, sweating, tight clothing, poor hygiene and conditions that reduce local skin protection.
- The causative agent is corynebacterium, which lives on the skin
- Only the superficial stratum corneum is affected
- Development condition: moisture and friction in folds
- Bacterial pigment gives stains a brown tint
- Infectiousness is low, but transmission through close contact is possible
Who gets sick more often
The main predisposing factors are diabetes and excess weight. With diabetes, the composition of sweat changes and local skin protection decreases, and deep folds in obese people create an ideal environment for the growth of bacteria. Increased sweating, working in hot conditions, wearing tight synthetic clothing and shoes, and rarely changing underwear are important. The disease is more common in adult men, older people and those who have limited mobility and personal care due to health reasons.
- Diabetes mellitus
- Excess weight and deep skin folds
- Excessive sweating
- Hot and humid climate, work in hot shops
- Tight synthetic clothing and closed shoes
- Decreased immunity, old age
Symptoms
The spots have clear, slightly scalloped borders and are pinkish to red-brown in color; Over time they darken. The surface is covered with small pityriasis scales, which are noticeable when rubbed. The lesions slowly expand along the periphery and may merge, but are never convex or covered with blisters. In the groin, the spots are symmetrical and are often limited to a fold, without extending to the scrotum - this is an important difference from a fungal infection. Between the toes, erythrasma appears as whitish softening of the skin with cracks. Itching is mild or absent, there is no pain.
- Well-defined red-brown spots
- Fine pityriasis-like peeling
- Localization in the groin, armpits, under the breasts
- Damage to the spaces between the toes
- Mild or no itching
- Slow expansion of lesions without bubbles
What examinations are needed
The simplest and most obvious method is examination in a darkened room under a Wood’s lamp: foci of erythrasma give a characteristic coral-red glow, which does not occur with a fungus. It is important that the skin is not washed before the examination, otherwise the luminous substance will be washed off and the result will be false negative. Be sure to scrape the scales for microscopy to rule out a fungal infection, since they are similar in appearance, but the treatment is different. All patients, especially those with widespread and recurring lesions, have their blood sugar levels checked.
- Examination under a Wood's lamp with a coral-red glow
- Do not wash your skin before examination
- Microscopy of scraping to exclude fungus
- Blood glucose and glycated hemoglobin
- Assessment of weight and condition of skin folds
- Culture if infection is suspected
Treatment and prevention
For limited lesions, external remedies are sufficient: the doctor prescribes antibacterial creams or solutions for a course of usually two weeks. With widespread damage and frequent relapses, a short course of oral antibiotic may be required - it is prescribed only by a doctor. The affected areas should be washed with mild products, thoroughly drying the skin after showering. Antifungal drugs for erythrasma without concomitant mycosis are useless, although some of them also have an antibacterial effect. The most important thing is to eliminate the conditions in which the bacteria multiply; otherwise, the spots will return within a few months.
- External antibacterial agents as prescribed by a doctor
- Oral antibiotic for common form
- Thorough drying of folds after washing
- Loose clothing made from natural fabrics, daily change of linen
- Weight loss and sugar control
- Drying powders and anti-sweating products