Erythrasma

Erythrasma is a superficial, chronic skin condition that causes pink patches that develop into brown patches. These patches are commonly found in skin folds, such as under the breast and in the groin, axillae, and toe webs (especially between the fourth and fifth toes). The condition worsens when occlusive clothing is worn and is more prevalent in obese patients and patients with diabetes. Erythrasma is found worldwide but is more prevalent in subtropical and tropical climates. It has a higher incidence in dark-skinned people. Men develop this condition more often in the groin area. (See Rash of erythrasma.)

Causes

Erythrasma is caused by Corynebacterium minutissimum, which is normally present on the skin. These bacteria invade the stratum corneum, the outermost layer of the epidermis. Risk factors for erythrasma include an immune-compromised state, excessive sweating, obesity, diabetes mellitus, poor hygiene, and advanced age. The condition occurs more often in warm weather.

Complications

Complications of erythrasma include wound infection, infective endocarditis and, possibly, septicemia, which may cause death in immune-compromised patients. Other infections that have been related to erythrasma include cellulitis, arteriovenous fistula, intravascular catheter–related infection, primary bacteremia, and meningitis. Recurrence of the condition may be considered a complication.

Assessment Findings

Patients with erythrasma present with brown-red macular patches that may cause itching. These patches are located in skin folds that are moist and generally occluded, although widespread involvement of the trunk and limbs may occur. The patches may be scaly, and the skin may appear macerated if toe webs are involved. These patches may remain on the skin for years. Patients are otherwise asymptomatic.