Presented by :

Ahmad Sharizal Devy Lianto Andi Nurul Ilmi

Advisor :

(C 111 07 313) (C 111 08 008) (C 111 08 001)

dr. Andy Anwar Aryad

Supervisor :

dr. Fitriyani Sennang A. Nanggung, M.Kes, Sp.KK

Dermatovenereolgy Department Medical Faculty Hasanuddin University Makassar 2011

Erythrasma is a chronic superficial infection of the intertriginous areas of the skin.

The incidence of erythrasma is reported to be around 4% More frequently in the subtropical and tropical areas

Both sexes are equally affected by erythrasma

Erythrasma increases with age

The incriminated organism is Corynebacterium minutissimum, which usually is present as a normal human skin inhabitant.

Corynebacterium minutissimum
Gram positive

Non-spore forming

Aerobic

Part of normal skin flora

Humid cutaneous microclimate

Warm and/or humid climate or season

Occlusive clothing/shoes

Obesity
Diabetes Mellitus

C. Minutissimum

Favorable condition

Clinical Manifestation

Colonization

Proliferation

History

Physical Examination
Woods Lamp

Microscopic Examination
Bacterial Culture

Usually Asymptomatic
Duration: weeks to months to years

Frequently misdiagnosed as tinea cruris or pedis

Site of predilection Toe webspaces Inguinal folds Axilla Groin Intergluteal Inframammary

Skin Lesion Patches, sharply marginated, macerated, eroded, fissured, red or brownish red. Pruriticexoriation, lichenification

Erythrasma: Well demarcated reddish-brown patches in the axilla

Erythrasma. Hyperkeratosis with a yellowish hue in the web space of the foot.

A. Revealed a diffuse, brownish, scaly plaqeu in bilateral intracrural areas of groin

B. Revealed a coral-red fluoresence (Woods lamp examination)

Gram strain of horny layer from erythrasma of the groin (A), gram strain of the scale from the web (B), and gram strain of smear from culture

Tinea Cruris

Tinea Pedis

Pityriasis versicolor

Potassiium Hydroxide: spaghetti and meatballs appearance

Tinea Pedis (interdigital type)

Tinea Cruris

Pityriasis Versicolor

Site of Predilection

Most: between fourth and fifth toes

Groins and thighs, may extend to buttocks

Upper trunk, upper arms, neck, abdomen, axillae, groins, thighs, genitalia

Wood Lamp

Yellow-green

Yellow-green

Blue-green (yellowish white or copper-orange)

Spagetthi and meatballs apperance Malassezia furfur

Direct microscopy

+ (septated hyphae and spora)

+ (septated hyphae and spora)

Culture

Dermatophytes can be isolated

Dermatophytes can be isolated

Topical therapy
Benzoyl peroxide (2,5 %) gel daily for 7 days. Fusidic acid cream (2%) Topical erythromycin/clyndamicin solution twice daily for 7 days Miconazole cream

Systemic
Macrolide : Erythromycin 250 mg (4 x daily) for 7 days
Tetracylin 250 mg for 7 days

Fatal septicemia in immunocompromised patients with erythrasma

Infective endocarditis in valvular heart disease patients with erythrasma

Postsurgical wound infection in erythrasma patients

The prognosis for erythrasma is excellent

The condition tends to recur if the predisposing factors are not eliminated