Erythrasma: Overlooked or Misdiagnosed?

Erythrasma: successful treatment after single‐dose clarithromycin

“…Multiple options are available for managing erythrasma, including oral and topical therapies. The frequently recommended treatment of choice is erythromycin 250 mg four times daily for 14 days 1–6 . Other oral treatment modalities include clarithromycin and tetracycline 1,5 …”

“…Clarithromycin is a macrolide that inhibits protein synthesis by binding reversibly to the 50S ribosomal subunit of bacteria with a high affinity for Gram‐positive bacteria like Corynebacterium minutissimum . Clarithromycin is structurally similar to erythromycin but differs by a hydroxy to o ‐methyl substitution at position 6 on the lactone ring 3,5,6 . This subtle change results in better bioavailability and gastric acid stability, longer half‐life, and a broader spectrum of action compared with erythromycin 3,5 .…”

Corynebacterium‐associated skin infections

“…No extensive demographic studies exist on erythrasma; however, inguinal erythrasma seems to be rare before puberty and there is no gender predilection 3 . Erythrasma is more common in overweight and obese patients, 25,26 the elderly, 27,28 and diabetics, especially in moist climates 16,29,30 . Some authors advise that a search should be made for diabetes mellitus in the presence of erythrasma 3,17 .…”

Erythrasma – A Red Herring in the Ongoing Epidemic of Tinea

“…[ 6 ] Obesity, diabetes mellitus, advancing age, and immunocompromised states can result in lesions appearing on non-flexural sites. [ 7 ] The lesions wax and wane leaving behind hyperpigmentation, or lichenification. In elderly persons with asymptomatic toe-web infection, erythrasma has also spread subungually causing melanonychia.…”

“…Awareness would prevent unnecessary antifungal medications and along with Wood’s lamp examination would enhance the diagnosis of erythrasma. [ 7 ] Occasionally, other Corynebacterium species cause erythrasma[ 1 ] or manifest in the person in diverse forms like pitted keratolysis and trichomycosis axillaris in addition to erythrasma. [ 10 ]…”