Common Diabetic Skin Condition

What is erythrasma?

Erytthrasma is a skin condition which is caused by a bacteria named Corynebacterium minutissimum. This bacteria is commonly found in diabetic patients and in warmer climates. Corynebacterium is a common inhabitant of human skin but can cause problems if the bacteria is present in high numbers. About 47% of people with itchiness and redness in between their toes has an erythrasma infection.

What are the symptoms?

Patient’s will typically see an area of a skin slowly enlarging of pink or brown patches usually found in-between the toes, underarms, groin, and are typically asymptomatic. Athlete’s foot infection can also exist in-between the toes at the same time. This can cause itching, burning, redness, and sometimes pain. Moist interdigital webspace can lead to a break down in the skin which can result in a bacterial infection. Soft tissue infection can progress rapidly and therefore if this is seen one should seek medical attention quickly.

What are the risk factors for erytrhasma?

Deep web spaces is commonly seen with this type of infection. The reason is the deeper web space holds moisture in between the toes and this environment is ideal for corynebacterium growth. Humidity and moisture within the shoe and in general the environment can lead to infection as well. A common situation is sweaty feet in a closed shoe. Often times the shoes are not breathable and therefore trap moisture. This can lead to an increased prevalence of erythrasma infections. Other risk factors include race. African Americans are more likely to develop this type of infection. Also, immunocompromised patients have a higher incidence as well. This is most likely because of the body’s inability to fight off the bacteria.

How do we diagnose erytrhrasma?

The podiatrist will use a Wood’s light which causes the skin lesions to fluoresce a red color. This red color is due to a chemical called poryphrins. Its the same natural compound that makes our red blood cells red in color. A skin biopsy may also be taken to determine the bacteria if the other physical signs are not present.

How do we treat erythrasma?

Antibiotics given orally or applied topically can be used to cure this infection. Erythromycin or tetracyclines can eliminate the infection. Antbacterial soaps such as chlorhexidine can also be of some benefit. If a fungal infection is also present then an anti fungal topical agent can also be applied.

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