Clinical and epidemiological features of coryneform skin infections at a tertiary hospital

Abstract

Background:Skin infections caused by coryneform bacteria are common dermatological conditions. However, to the best of our knowledge, no studies are available on the clinical characteristics and epidemiological features of this group of disorders as one entity from India and abroad.Aims:To study the clinical and epidemiological features of coryneform skin infectionsMethods:A total of 75 patients presenting with clinically distinctive lesions of pitted keratolysis, erythrasma and trichobacteriosis to our hospital were included in the study. Cases were interviewed with particular emphasis on epidemiological features and the various clinical findings were recorded. Investigations like Gram's stain, Wood's light examination, 10% KOH scrapings, were done in selected cases to ascertain the diagnosis.Results:Pitted keratolysis was more common in the age group of 31-40 years (40%) with a male preponderance (76.7%), most commonly affecting pressure bearing areas of the soles with malodour (86.7%) and frequent contact with water (58.3%) constituting the most important presenting symptom and provocating factor respectively. Erythrasma affected both male and female patients equally and was more commonly detected in patients with a BMI > 23kg/m2 (62.5%) and in diabetics (50%). All patients with trichobacteriosis presented with yellow coloured concretions in the axillae. Bromhidrosis (71.4%) and failure to regularly use an axillary deodorant (71.4%) were the most common presenting symptom and predisposing factor respectively.Conclusion:Coryneform skin infections are common dermatological conditions, though epidemiological data are fragmentary. Hyperhidrosis is a common predisposing factor to all three coryneform skin infections. Asymmetrical distribution of pits has been reported in our study. Diabetic status needs to be evaluated in all patients with erythrasma. Woods lamp examination forms an indispensible tool to diagnose erythrasma and trichobacteriosis.

Prevalence of superficial‐cutaneous fungal infections in Shiraz, Iran: A five‐year retrospective study (2015–2019)

“… 16 The collected samples were stained by methylene blue or Gram stain in erythrasma and PV suspected cases. 13 In addition, with wood's lamp, the bright coral red, and yellowish fluorescence indicated erythrasma and PV, respectively.…”

“… 12 Notably, some superficial bacterial infections of the skin and hair are frequently mimicking fungal infections, including erythrasma and trichomycosis axillaris. 13 , 14 Erythrasma is a superficial bacterial infection of the skin caused by Corynebacterium minutissimum . It is characterized by well‐demarcated scaly patches with reddish‐brown color in the body's intertriginous sites and causes itching, scaling, and erythema.…”

Tolio: Foot Rot in Grand Canyon River Runners

“…Some other less common bacteria have also been identified. 11 –14 These bacteria produce proteinases that destroy the stratum corneum, creating open small tunnels and pits, resulting in a “punched-out” or pitted appearance on the surface of the skin. 15 On the foot, it primarily affects the plantar aspect, especially pressure-bearing areas of the toes and the ball of the foot, but lesions can occur on the interdigital surfaces and arch.…”

Erythrasma: A Superficial Cutaneous Bacterial Infection Overlooked in Clinical Practice

“…9 Finally, a study from India showed a prevalence of erythrasma of 50% among patients with diabetes and 62.5% among those who are obese. 10 Erythrama occurs frequently in obesity and diabetes, two common conditions in internal medicine.…”

“…Many risk factors are associated with erythrasma, including hyperhidrosis and obesity, which are conditions that promote a moist environment and skin denudation. 10,11 Patients with diabetes or who are immunocompromised are at a higher risk of developing erythrasma as they have diminished defences against the bacterium. 12,31 Athletes and sportspersons are also at a higher risk as they are covered with clothing for prolonged periods, and sweat and friction promote bacterial multiplication.…”