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 ?
Fusidic acid ointment.
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
- Advanced age
- 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