Erythrasma: A Superficial Cutaneous Bacterial Infection Overlooked in Clinical Practice

Abstract

Erythrasma is a common superficial cutaneous bacterial infection caused by Corynebacterium minutissimum, a normal inhabitant of the skin surface. Under favourable conditions, the organism invades the stratum corneum, where it multiplies and produces clinically evident lesions. Increasing age, excessive sweating, diabetes mellitus, obesity, overcrowding and immunosuppression, including HIV, are risk factors for the disease. The condition can be confused with other infectious and non-infectious skin diseases, chiefly dermatophytosis. Erythrasma clinically presents in the groin, axilla, submammary, inguinal, intergluteal cleft and web spaces between the toes. Coinfection with fungi and superinfection upon primary dermatosis are common. Erythrasma can be diagnosed with a characteristic coral-pink fluorescence with Wood‘s lamp examination. Smears, biopsy and cultures are seldom required but are useful when the Wood‘s lamp test is negative. Atypical presentations do occur and require astute clinical judgment. This condition should be distinguished from other dermatosis as treatment is different. Treatment is with topical or oral antimicrobials, depending on the site and extent of the lesions. Recurrence can occur, and methods to prevent it should be in place. Novel treatments need robust testing prior to inclusion in the therapeutic armamentarium.