Erythrasma: Causes, Symptoms, Treatment and Cost

Corynebacterium minutissimum is the bacteria that is responsible for erythrasma, which is an infection of the skin.It mostly affects areas of the body that are warm and moist such as the groyne, armpit, between the toes and the navel.

There are two main types of erythrasma:-

• Intertriginous Erythrasma: Intertriginous erythrasma is usually found in skin creases on areas that have layers of skin touching each other such as folds around the anus, in between fingers and toes, underarms, or inner thighs. It can appear as dry reddish-brown patches with scaling or wrinkling of skin in between these areas. It is usually not itchy or painful but may cause discomfort if the person sweats a lot.
• Palmarosplantar Erythrasma: Palmarosplantar erythrasma is a type of erythrasma that appears on hands and feet as flat red scaly patches which extend beyond where your palms and soles meet your fingers and toes.

Erythrasma is brought on by a strain of bacteria called Corynebacterium minutissimum that is generally found on the surface of the skin.It occurs when the bacteria starts to grow in excessive amounts and causes inflammation of the upper layers of the skin.Factors that can increase the risk of getting erythrasma include living in hotter climates, having poor hygiene practices, having an excess level of sweat, and having an impaired immune system (e.g., HIV/AIDS).

• Symptoms usually present in the form of dry, scaly red or brown patches on the skin, especially between the toes and fingers, on chest and stomach, armpits and groyne areas.
• The affected area may appear shiny and result in discomfort such as itching or burning sensation with clothing friction or sweating.
• Itching due to the accumulation of sweat is a common symptom of erythrasma.

• Practise good hygiene by regularly washing the skin with soap and water.
• Wear loose, clean clothing and shower immediately after exercising or sweating heavily.
• Use an antifungal powder in areas prone to moisture, such as the armpits and groyne area.
• Avoid tight clothing as this may create an environment where Erythrasma thrives due to increased sweating, chafing and rubbing of the skin.
• Treat any other underlying fungal infections that may be present using prescription medications such as topical creams or systemic medications.

• Physical examination: In order to diagnose erythrasma, the patient’s medical history and a physical examination will be evaluated by their doctor.
• Potassium hydroxide test: This test may be performed on affected skin areas to demonstrate thin hyphae and spores under microscopic examination.
• Wood's lamp examination: Wood's Lamp examination may be used to view the reddish-brown fluorescence that may indicate erythrasma.
• Biopsy: A biopsy is a sample of tissue taken from the affected area for examination under a microscope to identify the bacteria and confirm the diagnosis.

• Aches and pains associated with the skin
• Secondary bacterial infection
• Pruritus
• Severe irritation of the skin in the affected area.
• Formation of open sores and blistering if left untreated.
• Increased skin sensitivity to sunlight or other forms of ultraviolet radiation.

• Applying coconut oil or ghee onto the affected area to help soothe the symptoms of erythrasma.
• Gargling with warm salt water may help lessen the erythrasma-related discomfort and edoema associated with the condition.
• Drinking turmeric milk can help to reduce inflammation and infections caused by erythrasma.
• Applying a mixture of green gram powder and yoghurt to the affected area can reduce the burning sensation caused by the infection.
• Intake of bitter melon can boost immunity and prevents recurrence of erythrasma symptoms.

• Eat Foods Rich in Antioxidants: Include a variety of foods that are high in antioxidants such as berries, leafy greens, carrots, sweet potatoes, and squash. Eating a diet rich in antioxidants helps reduce inflammation associated with the infection.
• Increase Your Omega-3 Intake: Research has shown that increasing one's intake of omega-3 fatty acids may aid in reducing infection-related inflammation.Aim to include more foods rich in omega-3 fatty acids such as chia seeds, walnuts, wild salmon, sardines, flaxseeds and hemp seeds into your diet on a regular basis.

• Raw and undercooked meats, including poultry, seafood, and eggs.
• Processed foods
• Refined grains
• High-fat dairy products
• Spicy or acidic foods like citrus fruits, vinegar, tomatoes and hot peppers.
• Sugary sweets and candies
• Alcoholic beverages.

• Medications: Medications used to treat erythrasma include topical antibiotics, anti-fungal creams, etc.
• Keeping the afflicted regions clean and dry is essential for the prevention and treatment of erythrasma.Avoiding damp and tight clothing, washing with soap and water, applying antifungal creams or powders, and drying the affected areas thoroughly after bathing can help reduce the chances of getting erythrasma or recurring symptoms.
• Hygiene: It is also important to practise good hygiene habits such as regularly changing clothes (especially underwear) and keeping any cuts or scrapes clean.
• Laser treatment: Laser treatment is an option for treating erythrasma, using specialised lasers that deliver pulses of light energy to the affected area of skin. The light energy passes harmlessly through the top layer into deeper layers where it kills off the bacteria responsible for causing erythrasma.
• Potassium permanganate soaks: This is a laboratory-made compound that is mixed with water to form a solution and soaked onto affected areas of the skin for several minutes each day until it clears up.

A dermatologist should be consulted for the diagnosis and treatment of erythrasma, an infection caused by bacteria that affects the skin. The dermatologist will examine the affected area and may take a sample for laboratory testing to confirm the diagnosis.

• Topical Antimicrobials: These include topical mupirocin, erythromycin, tetracycline, and clindamycin. These medications are typically used to treat localised skin infections caused by bacteria.
• Oral Antibiotics: Oral antibiotics such as doxycycline and cefadroxil may be used in more severe cases of erythrasma to fight the underlying bacterial infection that causes it.
• Antifungals: For cases of erythrasma that involve a fungal component, topical antifungal medications such as clotrimazole or econazole may be prescribed.

Erythrasma recovery often takes several weeks to several months, depending on the infection's severity and the patient's reaction to therapy. Recovery also depends on following doctor's advice and finishing all medications as prescribed.

The results of treatment for erythrasma are not necessarily permanent, as the condition may recur or worsen over time. Immediate treatment may reduce symptoms and control the spread, but longer-term management plans should be discussed with a healthcare provider.

• Post-treatment guidelines for erythrasma include:-
  • Wash the affected area with soap and water daily; apply an antifungal cream as prescribed by a healthcare professional.
  • Keep the skin dry, especially in between toes and other areas prone to sweating; wear loose-fitting clothing that allows the skin to breathe.
  • Avoid sharing items such as towels, clothing, and footwear to prevent spread of infection to others.
  • Health practitioners may also suggest taking oral antifungal medications or prescribed topical creams if necessary.

The cost of erythrasma therapy varies in India based on the kind and length of treatment, the severity of the illness, and other variables. Generally speaking, antifungal creams are available at an affordable cost, while medications such as antibiotics can be more expensive.

The typical cost associated with visiting a doctor and treating erythrasma in India is between Rs1,000 to Rs7,000; however additional costs may be incurred for medication or additional sessions.

• Common side effects of erythrasma treatment include redness, swelling, and itching of the area where the infection has occurred.
• Some people also experience peeling or dryness of the skin in the affected area.
• Blistering, pain, burning sensations and oozing may occur as well.
• In rare cases, allergic reactions such as hives or difficulty breathing can occur and should be monitored by a doctor for medical attention if necessary.

A doctor in your area should be seen if you have any erythrasma consequences as they may lead to skin pain and discomfort, secondary bacterial infections, and pruritus, for which treatment regimens can last anywhere from a few months to years, depending on the severity of the condition.