A 70 year old male patient who is obese and suffering from diabetes presents with a scaly skin lesion in the axilla.KOH examination from the lesion is negative and Wood light examination reveals coral-red fluorescence of lesions.
What is the treatment of choice ?
The patient in question is suffering from Erythrasma.
- It is a chronic superficial infection of the intertriginous areas of the skin.
- The incriminated organism is Corynebacterium minutissimum, which usually is present as a normal human skin inhabitant.
- The typical appearance of erythrasma is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scales
- Infection commonly is located on the inner thighs, crural region, scrotum, and toe webs. The axillae, submammary area, periumbilical region, and intergluteal folds are less commonly involved in erythrasma.
Predisposing factors for erythrasma include the following:
- Excessive sweating/hyperhidrosis
- Delicate cutaneous barrier
- Diabetes mellitus
- Warm climate
- Poor hygiene
- Other immunocompromised states.
- It is highly recommended to perform a direct KOH examination to exclude fungal infection.
- Wood light examination of erythrasma lesions reveals coral-red fluorescence of lesions.
- Erythromycin is the drug of choice. Infection may be treated with topical and/or oral agents