Estudio clínico del eritrasma en pacientes diabéticos / Clinical study of Erythrasma in diabetic patients

Este estudio se realizó para caracterizar la frecuencia de aparición, extensión, edad y sexo de la incidencia del eritrasma en pacientes diabéticos según el tipo, la duración y el estado. Estudio transversal y combinado de casos y controles de 200 pacientes diabéticos y 160 grupos no diabéticos que visitaron la consulta externa del Hospital Docente Al-Saddar, Departamento de Medicina y Dermatología, desde el período de diciembre de 2019 a julio de 2020. Dentro del grupo con Diabetes las edades oscilan entre los 12 y los 60 años con una edad media de 37,6 años. 148 pacientes padecían diabetes mellitus tipo no insulinodependiente (NIDDM) y 52 pacientes padecían IDDM. Entre todos los pacientes diabéticos examinados con la lámpara de Wood, para detectar infección por eritrasma, 34 (17%) resultaron afectados, de 26 hombres (76,5% de los afectados) y 8 mujeres (23,5%) se vieron afectados. Entre los 52 pacientes con DMID, 15 (28,8%) se vieron afectados y sólo 19 (12,8%) del resto con DMID se vieron afectados. Se encontró que la incidencia máxima de edad se encuentra en la cuarta década (30-40 años). El sitio de mayor propensión de las lesiones parecía ser la ingle en un 100%. La forma extensa o generalizada se encontró solo en 3 (8,8%) pacientes y el sitio menos afectado fue la membrana de los dedos solo en 2 (5,9%). La presentación de los pacientes fue asintomática en 22 (64,7%) y el cambio de color (marrón rojizo) se encontró en todos los pacientes. En conclusión, la aparición de eritrasma en pacientes diabéticos es más frecuente que su aparición en pacientes no diabéticos. Existe una asociación significativa entre la aparición de eritrasma y la IDDM. La frecuencia de aparición de eritrasma aumenta con la larga duración de la DM y más con la DM incontrolada

This study was conducted to characterize the frequency of occurrence, extent, age, and sex incidence of Erythrasma in diabetic patients according to the type, duration, and state. A cross-sectional and case-control combined study of 200 diabetic patients and 160 non-diabetic groups visiting the outpatient clinic of Al-Saddar Teaching Hospital, Department of Medicine and Dermatology, from the period of December 2019 to July 2020. Among the diabetic group, their ages range from 12-60 years with a mean age of 37.6 years. 148 patients were non-insulin-dependent diabetes mellitus type (NIDDM) and 52 patients were IDDM. Among all the diabetic patients examined by wood's light to detected Erythrasma infection 34(17%) were found to be affected, from 26 males (76.5% of the affected) and 8 females (23.5%) were affected. Among the 52 patients with IDDM, 15(28.8%) were affected and only 19(12.8%) from the remainder with NIDDM affected. The peak age incidence was found to be in the fourth decade (30-40 y). The site of greatest propensity of the lesions appeared to be the groin was 100%. The extensive or generalized form was found only in 3(8.8%) patients and the least affected site was the toe webs only in 2(5.9%). The presentation of the patients was found to be asymptomatic in 22(64.7%), and the color change (red brown) was found in all of the patients. In the conclusion, the occurrence of Erythrasma in diabetic patients is more frequent than its occurrence in non-diabetic patients. There is a significant association between the occurrence of Erythrasma and the IDDM. The frequency of occurrence of Erythrasma increase with the long duration of DM and more with the uncontrolled DM.

Interdigital foot infections: Corynebacterium minutissimum and agents of superficial mycoses

Interdigital foot infections are mostly caused initially by dermatophytes, yeasts and less frequently by bacteria. Erythrasma caused by Corynebacterium minutissimum can be confused with superficial mycoses. The aim of the study was to determine the prevalence of the etiologic agents of superficial mycoses and the frequency of Corynebacterium minutissimum in interdigital foot infections. All the samples obtained from the 121 patients with interdigital foot infections were examined directly with the use of 20% potassium hydroxide mounts and Gram stain under the microscope and cultured on Sabouraud's dextrose agar plates. In identification of superficial mycoses, the rate was found to be 14% with the cultural method and 14% with direct microscopic examination. Using a combination of direct microscopic examination and culture, a 33.8% ratio was achieved. In the culture of these samples, the most isolated factor was Trichophyton rubrum (33.7%). In 24 of the patients (19.8%) Corynebacterium minutissimum was detected by Gram staining, in 6 of these patients Trichophyton rubrum was found, Trichophyton mentagrophytes was found in 2 and Trichosporon spp. was found in 1. The examination of interdigital foot lesions in the laboratory, the coexistence of erythrasma with dermatophytes and yeast should be considered.

[Molecular identification of corynebacterium minutissimum in skin lesions suspicious for erythrasma by the PCR method]

Erythrasma is a chronic superficial infection of the intertriginous areas. Most laboratories use methylene blue stain and 10% KOH smear to identify Corynebacterium minutissimum [C. minutissimum] by direct observation of filamentous bacilli. Occasionally atypical forms can be seen that create problems in diagnosis. This study aims to use the polymerase chain reaction [PCR] method in order to definitively identify C. minutissimum as an agent of erythrasma. This research was performed during 2013 on 100 skin scrapings suspicious for erythrasma which were obtained from various medical mycology laboratories in Tehran. Samples were tested by three methods - direct examination, culture and PCR. DNA was extracted by the modified phenol-chloroform method after which PCR was performed using designed primers. We sequenced some of the PCR products. The sensitivity and specificity of the PCR method was compared to the direct and culture examinations. Of the 100 samples, there were 25 positive samples according to PCR analysis, 13 positive by direct examination and 23 that cultured positive. DNA sequencing results showed the presence of C. minutissimum. The PCR method in comparison with direct examination had a sensitivity of 100% and a specificity of 86.2%. The study also showed that the PCR method in comparison with culture had a sensitivity of 100% and a specificity of 97.4%. This study showed that the PCR method in comparison with the direct method and culture had a higher sensitivity in the detection of C. minutissimum. The present PCR method confirmed all typical and some of the atypical forms of C. minutissimum which indicated the importance of this method in the definitive diagnosis of erythrasma

Postoperative Abdominal Infection Caused by Corynebacterium minutissimum / 감염과화학요법

Corynebacterium minutissimum is a non-spore forming, gram-positive, aerobic or facultative anaerobic bacillus. It is the causative organism of erythrasma, a common superficial infection of skin, which typically presents as reddish-brown macular patches. To date, it has rarely been found to cause invasive disease, although other non-diphtheria corynebacteria are becoming increasingly common as opportunistic pathogens. We report on a rare case of abdominal infection due to C. minutissimum in an immunocompetent adult who was successfully treated with intravenous amoxicillin/sulbactam.

Eritrasma, revisión / Erythrasma, review

El eritrasma es una infección superficial de la piel que afecta la capa córnea y es causado por una bacteria grampositiva, Corynebacterium minutissimum. Se presenta como manchas eritematosas a marrón en grandes pliegues y como descamación y maceración en pliegues interdigitales; es asintomática, aunque en algunos casos se acompaña de prurito. El diagnóstico es clínico por luz de Wood que da una fluorescencia rojo coral de las áreas afectadas. Su curso es benigno, aunque persiste si no se da un tratamiento adecuado.

Erythrasma is a superficial skin infection of the stratum corneum caused by a gram-positive bacteria, Corynebacterium minutissimum. It is characterized by reddish-brown areas affecting occluded intertriginous zones such as axillae, inframammary folds, and as irregular scaly patches or macerated lesions on toeweb spaces. It is asymptomatic, though sometimes accompanied by pruritus. Clinical diagnosis is supported by a red fluorescence under Wood s light examination. It is benign, yet persistent if not adequately treated.

A Clinical Analysis of 133 Cases of Pitted Keratolysis / 대한피부과학회지

BACKGROUND: Pitted keratolysis (PK) is an acquired, chronic, usually asymptomatic, non-inflammatory, superficial bacterial infection of the stratum corneum of the soles. Corynebacterium species are thought to be the causative organisms of PK. This condition is common in feet of active people wearing sweaty shoes, namely, athletes and soldiers. OBJECTIVE: To analyze the clinical manifestations of pitted keratolysis. METHODS: A total of 133 Korean male soldiers diagnosed with PK (aged between 19 and 33, mean 21.9 years) were included in this study. All patients were investigated between April 2004 and May 2005. Factors investigated included age, location, duration, date of visit, physical examination, subjective symptoms, associated medical conditions, and treatment modalities. All patients were examined carefully to verify accompanying erythrasma or trichomycosis axillaris (TMA). RESULTS: About half of the patients visited our department in spring (March, April, and May). However, PK was found in all the seasons. The ball of the foot was the most frequently involved site (92.5%). The big toe (72.2%) was also a frequent site of involvement. Forty-five patients (41.7%) had coexistent erythrasma, 22 (20.4%) had TMA, and 14 (13.0%) had a simultaneous presence of both erythrasma and TMA. Hyperhidrosis (98.5%) and foul odor (95.5%) were the main complaints in most of the patients. Other symptoms associated with PK were sliminess (38.3%), burning (23.3%), itching (18.8%), and prickling (13.5%) sensations. Various treatment modalities such as topical antibiotics, topical antifungal agents, and oral erythromycin have been used. All lesions subsided within 1 month after treatment. Although recurrence rate was high (64.3%), parameters such as period of prevalence, size and shape of the lesion, and treatment modality were not associated with the recurrence rate. CONCLUSION: The present study provides basic clinical information on PK, which is a common condition of the feet of Korean male soldiers.

Comparative Study of Benzoyl Peroxide Versus Clindamycin Phosphate in Treatment of Pitted Keratolysis / 대한의진균학회지

BACKGROUND: Pitted keratolysis (PK) is a bacterial infection of the stratum corneum. The infection is characterized by 1 to 7 mm discrete and coalescing craterlike pits on the plantar surfaces of the feet and toes, especially the weight-bearing areas. Topically applied antibiotics such as clindamycin, benzoyl peroxide erythromycin, and clotrimazole are curative. OBJECTIVE: We performed this study to compare treatment efficacy of benzoyl peroxide (BP) and clindamycin phosphate (CP) in PK. METHOD: The clinical study was made in 44 patients with PK. Among 44 patients, 17 patients were treated by BP topical application alone, 15 patients treated by CP. And the others by combined topical application of BP and CP. RESULT: There were no significant differences in the treatment efficacy between BP and CP, and between monotherapy and combination therapy, neither. 1) Gender ratio showed extreme male predominance (M: F = 43: 1), and the mean age of onset was 22 years old. 2) Mean disease duration was 2.8 months and mean period for complete cure was 2.6 weeks. And there was no significant relation between disease duration and mean period for complete cure. 3) Hyperhidrosis (18.1%) was the most commonly associated condition with PK. The followings were Tinea pedis (13.6%), T. cruris (6.8%), erythrasma (6.8%), cellulitis (6.8%), osmidrosis (6.8%), wart (6.8%), and corn (6.8%) in the order of frequency. 4) There was no statistically significant difference in the treatment efficacy between BP and CP (p> 0.05). 5) Among 44 patients, irritation was observed in 4 cases (9.1%). Two cases were related with BP, and the others with CP. But these adverse effects were trivial and disappeared soon. 6) Four cases (9.1%) showed recurrence within 3 month-follow up. And they were all related with hyperhidrosis. There was no statistically significant difference in the recurrence rate between BP and CP, although patients treated with CP showed slightly higher recurrence rate (p> 0.05). CONCLUSION: Our study shows that no significant difference in the treatment efficacy between benzoyl peroxide and clindamycin phosphate, and between monotherapy and combined therapy, neither. Therefore, combination therapy should be spared for only intractable PK.

Intertrigo em pacientes com linfedema de membro inferior: correlacao clinico-laboratorial / Intertrigo in patients with lower limb lymphedema: clinical and laboratorial correlation

Lesoes cutaneas interdigitais sao frequentes em pacientes com linfedema de membros e sua prevencao e tratamento sao importantes no controle da doenca e prevencao de complicacoes infecciosas. Material colhido da regiao interpododigital de 21 pacientes com linfedema dos membros inferiores do Ambulatorio da Unidade de Linfedema do Servico de Cirurgia Vascular do Hospital das Clinicas da FMUSP foram estudados atraves de exame micologico direto, cultura para fungos e exame direto por luz fluorescente. Treze dos pacientes apresentaram lesoes clinicas sugestivas de intertrigo (61,9 por cento). Em 11 destes pacientes, demonstrou-se presenca exclusiva de fungos em sete pacientes, Corynebacterium minutissimum em dois e associacao de fungos e bacterias em outros dois pacientes...

Búsqueda intencionada de eritrasma y su frecuencia relativa en la consulta del servicio de dermatología / Intentional search of erythrasma and its relative frequency in the outpatient dermatological clinic

El eritrasma es una enfermedad asintomática que pertenece a las corinebacteriosis. En un estudio retrospectivo se encontraron cinco casos de eritrasma en grandes pliegues en 30 meses. Se presenta un estudio prospectivo de cuatro casos de eritrasma de topografía interdigitopodal en un periodo de un año, donde la lámpara de Wood demuestra su utilidad diagnóstica. La frecuencia relativa aumentó de 2.7 a 4.7 por 1,000

Eritrasma una revisión / Erithrasma. A review

Se comentan los datos históricos, microbiológicos, patógenos y epidemiológicos del eritrasma, así como sus características clínicas y de laboratorio y su tratamiento. El agente causal es Corynebacterium minutissimum y se menciona que el eritrasma es una enfermedad común en nuestro medio, aunque se desconoce su frecuencia real. Es posible que sea mal diagnosticada o poco reportada debido a su relativamente fácil diagnóstico o a su favorable reacción ante los diversos tratamientos existentes

A Case of Generalized Annular Lichen Planus Controlled by Erythromycin / 대한피부과학회지

A 69-year-old man presented with annular lichen planus involving both forearms, hand dorsa, wrists, inner sides of the thighs, knees and ankles. He was treated initially with systemic corticosteroids and etretinate, but rernission and recurr ence of the skin lesions were observed. During the follow-up, we found erythrasma on all his toewebs and both soles. After administration of erythromycin for the treatment of erythrasma, lesions of the lichen planus rapidly improved. Five months later, some lesions of lihen planus and erythrasma had recurred. After administration of erythromycin, the lesions of lichen planus improved again. No recurrence was observed for the following 8 months. We suspect that eradication of the chronic focus of infection and the anti-inflammatory effect, of erythromycin may lead to supression of abnormal immunological reactions and resolution of lichen planus.

Single method to stain Malassezia furfur and Corynebacterium minutissimum in scales

E descrito um metodo simples e pratico para corar Malassezia furfur e Corynebacterium minutissimum nas escamas das lesoes. O material e colhido com o auxilio de fita durex que sera usada na maior parte das etapas do metodo para ajudar a facil execucao do processo de coloracao. Para colher as escamas, pequenos pedacos de fita durex com cerca de 4 cm de comprimento por 2 cm de largura sao colocados e pressionados sobre as lesoes, e quando retirados trazem aderidas as escamas furfuraceas na face com goma. Esses pedacos de fita durex sao imersos por alguns minutos no corante lactofenol-azul cotton e logo que as escamas estiverem coradas em azul sao lavadas em agua corrente para remover o excesso de corante azul, secos com papel de filtro, desidratados pela passagem em dois frascos de centrifugacao com xilol. O xilol dissolve a goma da fita durex e as escamas caem soltas no tubo. Apos centrifugacao e decantacao as escamas concentradas no fundo do tubo sao colhidas com alca de platina, colocadas em balsamo de Canada sobre uma lamina de microscopia e fechadas com uma laminula...

The Incidence and Culture of Erythrasma in Korea / 대한피부과학회지

BACKGROUND: The authors did not find any study about erythrasma in Korea, where as there are several studies about the incidence and bacteriology of erythrasma in some areas. Failure to differentially diagnose the clinical entities of tinea pedis versus erythrasma can lead to mistreatment and disability because of the clinical similarities. OBJECTIVE: This study was carried out to investigate the incidence of erythrasma according to the seasons and sites, to determine the useful culture media, and to evaluate the antibiotic sensitivities and the treatment responses. METHODS: The incidence of erythrasma was investigated among the unselected dermatologic patients. The axillae, groins and toewebs were examined under Wood's light. The scale showing characteristic coral-red fborescence was Gram-stained and Corynebacterium minutissimnm was cultured using Loeffler slant media, Brucella blood agar plates and usual blood agar plates. RESULTS: Clinical erythrasma was found in 26.7% of the 240 patients examined. The incidences of erythrasma in summer and fall were higher than winter In the bacteriologic study Gram positive cocco-bacilli were found in all erythrasma patients and Corynebacterium minutissimum was cultured and identified in 24 0%. Most of cultured causative organisms were sensitive to usual antibiotics in the clinical uses. The average interval from the oral administration of erythrasma to the loss of coral-red fluorescence was 4.1 weeks, and the patients in severe erythrasma group were needed more time(2.2 weeks) for clinical improvement than the patients in mild one. CONCLUSION: Erythrasma is common in the dermatologic patients and it is important to differentially cliagnose the clinical entities of tinea pedis versus erythrasma.

La reacción del ácido peryódico Sciff más dimetilsulfóxido para el diagnóstico de micosis superficiales y de eritrasma en raspaduras de la piel y de las uñas / PAS plus DMSO stain for rapid diagnosis of superficial fungal infections and erythrasma

La tinción del PAS más DMSO, es un método sencillo y rápido mediante el cual las raspaduras de lesiones de la piel o de la uñas, recogidas con una laminilla a la que se le ha aplicado albúmina de Mayer en su superficie, puede examinarse microscópicamente y determinar con precisión la ausencia o presencia de hongos y de Corynebacterium minutissimum. El método, además, permite obtener preparaciones permanentes

Investigación de portadores de Nocardia minutissima en pliegue perigenital / Carriers state study of Nocardia minutissima in perigenital region

Se estudió la existencia de portadores sanos de Nocardia minutissima en escamas de la región perigenital de 130 varones adultos. Este microorganismo fue encontrado en 4 casos (3,08%) en tanto que 23 (17,69%) mostraron elementos levaduriformes, 15 (11,54%) portaban Pityrosporum ovale y sólo 1 (0,77%) tuvo filamentos de un dermatofito. La baja frecuencia de portadores sanos de Nocardia minutissima concuerda con la relativa rareza del eritrasma inguinal en la actualidad

A Case of Erythrasma / 대한피부과학회지

Erythrasma is a chronic, superficial bacterial skin infection involving the body folds and toewebs, and sametimes it may be generalized. The causative organism of this disease is Corynebacterium minutissimum. But, in Korea, there are few reported case about this common condition. We experienced a case of erythrasma on 39-year-old male who have had well defined, brownish fine scaly patches on both crural areas for 15 years. We had treated this patient with topical antifungal agent for 1 month under impression of tinea cruris, But skin lesion was not improved. So, we reexamined the lesion and diagnosed it as genitocrural form of erythrasma with it's clinical appearance, red fluorescence under Wood's light. And we treated it with oral erythromycin.

Estudo do agente etiologico do "eritrasma". I - Caracterizacao dos difteroides fluorescentes. / Etiologic agent of erythrasma. I - Characterization of the fluorescent diphtheroids

Foi realizado estudo bacteriologico com o agente etiologico do eritrasma. Os resultados obtidos indicam que sob o ponto de vista bioquimico o C. minutissimum corresponde a um grupo complexo. Todas as amostras estudadas foram enquadradas nos biotipos propostos por diversos autores para esse microrganismo; ate tres tipos diferentes de difteroides fluorescentes foram isolados do mesmo paciente; em alguns casos difteroides de fluorescencia rosea foram isolados juntamente com aqueles de fluorescencia vermelho coral. Pelas caracteristicas bioquimicas observadas neste trabalho, conclui-se que o agente do eritrasma e semelhante a diferentes especies de Corynebacterium anteriormente descritas. Propoe-se um esquema de grupagem simples com 5 biotipos