RESUMO
BACKGROUND: Erythrasma is a chronic bacterial infection due to Corynebacterium minutissimum, affecting the interspaces of the toes, the axillary folds and the groin. Its impact is underestimated as it is often misdiagnosed ad wrongly taken as a dermatophytic infection. AIM: Through a hospital series, we report the epidemiologic and clinical features of erythrasma, as well as the therapeutic ways. methods: A retrospective study over a 20 year period and including the patients diagnosed as having erythrasma after a Wood's light examination. results: There were 16 patients (6 males and 10 females) with an average age of 44.6 years-old. The majority of our patients consulted on hot season. Clinical examination showed macular plaques with clear limits, erythematous in 6 cases and yellowish in the remaining cases. The lesions were located at the axillary folds in 13 cases; the groin in 2 cases and at all folds in one case. Treatment with erythromycin (topical or general administration) was the most prescribed. Outcome was generally favourable, but recurrences have been noticed. CONCLUSION: Erythrasma is a frequent misdiagnosed infection and often confused with a mycosis (especially in the interspaces of the toes); knowing that antimycotic agents are efficient in erythrasma. This is probably the reason of the small number of patients in our series.
Assuntos
Eritrasma/epidemiologia , Adulto , Antibacterianos/uso terapêutico , Eritrasma/diagnóstico , Eritrasma/terapia , Eritromicina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico/métodos , Estudos Retrospectivos , Tunísia/epidemiologiaRESUMO
Antecedentes. El eritrasma es una infección superficial causada por Corynebacterium minutissimum, que afecta grandes pliegues y regiones interdigitales de los pies. Existe eritema, descamación, manchas color marrón y maceración; se presenta con fluorescencia rojo coral con luz de Wood. Objetivo. Determinar la frecuencia de eritrasma en pacientes con lesiones interdigitales. Métodos. Se realizó un estudio prospectivo, abierto, observacional y longitudinal en un hospital de la ciudad de México de marzo a diciembre de 2006. A todos los pacientes con lesiones interdigitales se les realizó luz de Wood, examen directo con hidróxido de potasio al 20 %, cultivo en agar dextrosa Sabouraud, frotis y cultivo en infusión cerebro-corazón. Se documentaron los datos generales y enfermedades concomitantes. Resultados. Examinamos 73 pacientes, 24 (32,8 %) presentaron eritrasma diagnosticado por la fluorescencia rojo coral y la identificación de la corinebacteria por tinción de Gram. Fue más frecuente en mujeres (83,33 %) y la edad promedio fue 43,5 años. Los principales datos clínicos fueron descamación y maceración y el cuarto pliegue fue el más afectado. En ningún caso se pudo aislar el microorganismo en el cultivo. El examen micológico fue positivo en 15 casos (62,5 %) y se aislaron: Candida (16,6 %), dermatofitos (12,5 %) y Trichosporon (4,1%). Conclusiones. El eritrasma interdigital es frecuente y puede confundirse fácilmente con tiña interdigital. Es persistente sin tratamiento adecuado. El diagnóstico es rápido y accesible con luz de Wood y el cultivo es difícil y no es indispensable para el diagnóstico. Debe considerarse la coexistencia de eritrasma con dermatofitos y Candida cuando afecta los pliegues inerdigitales (AU)
Background. Erythrasma is a superficial infection caused by Corynebacterium minutissimum and affects the major skin folds and the interdigital regions of the feet. It is characterized by erythematous, brown, scalypatches and maceration, and exhibits coral-red fluorescence under Wood light. Objective. The aim of this study was to determine the frequency of erythrasma in patients with interdigital lesions. Methods. An open, prospective, longitudinal, observational study was performed in a hospital in Mexico City between March and December, 2006. All patients with interdigital lesions were examined with a Wood lamp and direct examination was performed with 20 % potassium hydroxide. Cultures were done in Sabouraud dextrose agar and brain heart infusion agar, and smears were analyzed. General characteristics and concomitant diseases were recorded. Results. We examined 73 patients, of whom 24 (32.8%) were diagnosed with erythrasma based on coral-red fluorescence under Wood light and identification of corynebacteria by Gram staining. The disease was more common in women (83.33 %) and the mean age of the patients was 43.5 years. The main clinical findings were scaling and maceration, and the fourth interdigital web was the most commonly affected. Corynebacterium could not be isolated in any of the cases. Mycology was positive in 15 cases (62.5 %) and the following microorganisms were isolated: Candida (16.6 %), dermatophytes (12.5 %), and Trichosporon (4.1 %) (AU)
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Eritrasma/diagnóstico , Eritrasma/epidemiologia , Eritrasma/terapia , Dermatite de Contato/epidemiologia , Eritromicina/uso terapêutico , Tetraciclina/uso terapêutico , Espectrometria de Fluorescência/métodos , Dermatomicoses/epidemiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Eritrasma/patologia , Dermatomicoses/diagnóstico , Infecções por Corynebacterium/epidemiologia , Eritema/complicações , Muda , Estudos Prospectivos , Sinais e Sintomas , México/epidemiologia , Dedos do Pé/patologiaRESUMO
El eritrasma es una infección superficial de la piel que afecta la capa córnea y es causado por una bacteria grampositiva, Corynebacterium minutissimum. Se presenta como manchas eritematosas a marrón en grandes pliegues y como descamación y maceración en pliegues interdigitales; es asintomática, aunque en algunos casos se acompaña de prurito. El diagnóstico es clínico por luz de Wood que da una fluorescencia rojo coral de las áreas afectadas. Su curso es benigno, aunque persiste si no se da un tratamiento adecuado.
Erythrasma is a superficial skin infection of the stratum corneum caused by a gram-positive bacteria, Corynebacterium minutissimum. It is characterized by reddish-brown areas affecting occluded intertriginous zones such as axillae, inframammary folds, and as irregular scaly patches or macerated lesions on toeweb spaces. It is asymptomatic, though sometimes accompanied by pruritus. Clinical diagnosis is supported by a red fluorescence under Wood s light examination. It is benign, yet persistent if not adequately treated.