What is erythrasma in women and men, signs and treatment

Erythrasma belongs to the group of dermatological diseases, caused by a gram-positive rod - corynebacterium and is a representative of the group of pseudomycoses. Usually the skin located in the natural recesses and folds of the body is affected. The bacterial agent is transmitted by contact when walking barefoot, as a result of direct contact of the interdigital spaces of the feet with contaminated soil. In addition, the contact mechanism of transmission of infection from a sick person is described. Further, corynebacterium spreads to larger folds of the body - inguinal-femoral, armpits, in the area under the mammary glands, in the peri-umbilical and intergluteal space. The disease affects the surface layer of the epidermis, and hair follicles and nails are not involved in the pathological process. The main predisposing factor for the disease is the active functioning of the sweat glands in hot climates with high humidity. These moments provoke the development of microcracks and macerations, which in turn triggers the pathological process. Adults, mostly males, and rarely children, are most often affected.

What is pityriasis versicolor

Pityriasis versicolor, or pityriasis versicolor, is a chronic skin disease of a fungal nature. It appears in the form of specifically pigmented spots of various sizes and shades, without signs of inflammation. Most often, the areas affected by pityriasis versicolor are located on the body (back, abdomen, neck, shoulders) and scalp. Representatives of both sexes are most susceptible to the disease at a young age, and children under 7 years of age are the least susceptible.

External manifestations of the disease usually do not cause concern, so they are often perceived as harmless cosmetic defects. For this reason, the pathology becomes chronic: spots periodically appear, then disappear, and after some time, under the influence of provoking factors, the disease worsens again.

Indications and contraindications for use

The list of pathologies for which the ointment is recommended is presented:

• genital candidiasis complicated by trichomoniasis;
• dermatomycosis;
• dermatophytosis;
• mycoses complicated by infection of pyogenic cocci.
• thrush;
• some types of lichen;
• paronychia;
• superficial candidiasis;
• stomatitis;
• erythrasma.

The drug is contraindicated:

• in the first trimester of pregnancy;
• for abrasions, wounds, skin erosions;
• intolerance to component components.

Use in the second and third semesters of pregnancy requires the permission of a doctor; during lactation, it is prohibited to apply the ointment to the breast. The medicine is prescribed to newborns with restrictions:

• A small area of ​​skin is subjected to the procedure;
• Large lesions are treated in parts.

The medication in the form of powder is prescribed to infants with an infected type of diaper rash. Treatment of fungal infections is important for pathologies that cause drying of the dermis.

Symptoms of the disease

When infected with pityriasis versicolor, the pathogens multiply in the superficial layers of the skin, disrupting the normal functioning of cells. First of all, melanocytes, which are responsible for the production of the pigment melanin, are affected, thanks to which the skin has one color or another. This means that under the influence of pathogenic microorganisms, the affected areas acquire an uncharacteristic, painful shade. Hence the second name for pityriasis versicolor - versicolor.

The main symptoms of pityriasis versicolor include:

1. Spots of yellow, coffee, scarlet or dark brown shades, located mainly on the back, head and neck, shoulders and stomach. In children, they also appear on the limbs, armpits and scalp. The affected areas can be of different sizes, but usually their size does not exceed 1 cm. Subsequently, the spots merge with each other, forming significant areas of the affected skin.
2. No signs of inflammation in the form of redness, swelling, hyperemia and pain to the touch.
3. Severe peeling of the skin in infected areas, aggravated by touch.
4. No tanning on the affected areas.

Pityriasis versicolor is not characterized by itching and discomfort, so patients often mistake the manifestations of the disease for minor cosmetic defects, postponing a visit to the doctor and full treatment.

Such spots begin to itch and scratch only if a secondary infection occurs.

Reasons for development

Versicolor versicolor is a type of fungal skin infection that affects the stratum corneum of the epidermis and hair follicles. Its causative agents are two types of fungi, and infection is possible only through prolonged and close contact with the patient. And in this case, provoking factors play a big role. These include:

• weakened immunity;
• hyperhidrosis;
• disruption of the sebaceous glands;
• diseases of the endocrine system (obesity, diabetes, Itsenko-Cushing syndrome, etc.);
• hormonal imbalance due to pregnancy, menopause or taking hormone-containing medications;
• vegetative-vascular dystonia;
• abuse of antibacterial personal hygiene products;
• excessive exposure to ultraviolet rays (intense tanning, frequent visits to the solarium) and regular overheating of the body.

It is noteworthy that patients with pityriasis versicolor over 60 years of age are extremely rare. This is due to natural age-related changes in the skin, which make it less susceptible to pathogens.

In children under 10 years of age, the main causes of pityriasis versicolor infection are neglect of personal hygiene rules or improper skin care. At this age, with the protective functions of the skin intact, the body independently copes with pathogenic microorganisms attacking it, so the development of the disease does not occur. But closer to adolescence, when hormonal changes begin, the body’s susceptibility to bacteria, viruses and fungi increases, so children over 10 years old become infected with pityriasis versicolor just like adults.

Recommendations and prevention

The duration of the fight against corynebacteria largely depends on compliance with hygiene rules. It is necessary to maintain not only cleanliness, but also dry skin. The risk of self-infection is very high - particles of the affected epithelium in the form of exfoliated scales settle on underwear, clothes, towels, shoes, etc. At the next contact, they again appear on the skin as a source of new infection. To avoid this, the following recommendations should be strictly followed.

• Clothes, underwear and shoes of a patient with erythrasma must be washed especially carefully at high temperatures with a strong SMS.
• Linen and underwear should be changed daily, and be sure to be ironed before putting on.
• It is advisable to take a shower with antibacterial soap (baths are excluded for now).
• After a shower, dry all skin folds well.
• After the stains disappear, wipe their places with a solution of 0.1% Riivanol for at least a month. It dries and disinfects the skin.
• Refusal of tight clothes and underwear, selection of things strictly according to size with a small margin.
• Preference for natural fabrics that allow air to pass through well.
• Fight sweating with antiperspirants, antiseptics, and deodorants.

Patients with diabetes mellitus, pregnant and lactating women should be especially attentive to the manifestations of erythrasma. The first one needs to constantly monitor blood glucose levels and be under the supervision of an endocrinologist. Pregnant and lactating women need to choose a course of treatment with minimal impact on the fetus and milk composition.

Complications of erythrasma include diaper rash and secondary infections. Patients with diabetes mellitus, immobile people and those suffering from hyperhidrosis are most susceptible to them. Another risk group is those who are too careful about their own hygiene. When washing your body several times a day and constantly using hand sanitizers, the natural protective barrier is disrupted and increased sweating occurs. Our simple recommendations will allow you to avoid its consequences and cure erythrasma once and for all.

Treatment of pityriasis versicolor

The diagnosis of pityriasis versicolor is made to the patient after examination by a dermatologist and dermatoscopy. Additionally, an iodine test and laboratory testing of scrapings can be used.

Treatment of pityriasis versicolor is carried out on an outpatient basis until the symptoms of the disease completely disappear. If measures were taken on time, the patient is prescribed local therapy using antifungal ointments and special agents for exfoliating dead cells.

Additionally, immunomodulators, vitamin complexes, antifungal shampoos and antihistamines are used if the patient is bothered by itching. In the most advanced cases, antimycotic agents are prescribed for oral administration. In addition, in order to avoid relapse of the disease and infection of others, the patient’s clothing and bedding are treated with disinfectant compounds.

Disease prevention also plays an important role. The following will help prevent the development of the disease:

• timely solution to the problem of hyperhidrosis (use of medicinal deodorants, creams, powders, compliance with personal hygiene rules, frequent changes of underwear, etc.);
• use of high-quality soaps and skin care products;
• regular water procedures;
• wearing clothes made from natural, hypoallergenic materials;
• avoiding stress;
• balanced diet rich in vitamins and microelements.

Experts also recommend avoiding overheating of the body and promptly seeking advice from cosmetologists and dermatologists in order to identify the problem and begin proper treatment.

What is erythrasma

Erythrasma is a chronic bacterial disease affecting the epidermis layer in the deep folds of the skin. It is characterized by a long course - in some cases, symptoms develop for at least 10 years, without causing significant discomfort to the patient. The clinical picture of erythrasma is similar to a fungal infection of the skin, but modern dermatology classifies it as a group of pseudomycoses.

The following main stages are distinguished in the development of the disease:

1. Progression. The first characteristic spots appear on the skin, their size slowly increases, and additional symptoms develop. In some cases, secondary infections occur. The spots gradually merge with each other, forming large areas of damage.
2. Stabilization. New spots do not appear, and existing ones stop growing. Peeling of the skin begins. This stage is usually associated with a change in external conditions, for example, cold weather, during which the intensity of sweating decreases and the skin condition stabilizes.
3. Exacerbation or relapse. Usually associated with the beginning of the warm season. But in the case of prolonged erythrasma, the disease constantly develops in waves, and after a slight decline its symptoms again actively appear.
4. Remission. Occurs with a favorable microclimate, compliance with preventive measures and proper skin care. The color of the affected areas gradually returns to normal, itching and flaking disappear, and the skin is restored.

Without timely, well-chosen treatment, erythrasma can lead to the development of serious complications.

For example, it can provoke eczema and secondary infection in patients with diabetes or obesity. Also, the course of the disease is aggravated by increased humidity and contamination of the affected areas. As a result, its typical symptoms are complicated by burning, itching and pain.

Stages of erythrasma and their characteristic symptoms

In accordance with the characteristic symptoms of erythrasma, the following stages are distinguished.

• Progression. It is characterized by the formation of primary spots, their slow growth, the addition of other symptoms, and secondary infections. Spotting may persist for several months. Progression is expressed both by an increase in the area of ​​the first spot and by the appearance of new ones.
• Stabilization. There is no obvious growth of previously appeared spots and the formation of new ones. At first, slight, not too bothersome peeling is possible. In this condition, the symptoms of erythrasma (dry reddish spots) can persist until the microclimate changes - the ambient temperature, humidity and other factors that provoke sweating decrease. In hot southern climates, spotting can be permanent. In regions with clear seasonal differences in weather conditions, the symptoms of erythrasma “subside” until the next period favorable for corynebacteria.
• Relapse. Available in two versions. The first is seasonal in nature - spots appear annually under the same conditions - in the summer with persistently hot weather. The second is characteristic of prolonged erythrasma, when spots that have already noticeably paled and decreased in size begin to grow again, itching, burning, weeping, and swelling appear.
• Remission. It occurs when the microclimate changes. As soon as the air temperature and humidity decrease, friction of skin areas against each other is eliminated, the inflammation goes away. The color of the affected areas fades, peeling decreases, swelling goes away and the skin condition gradually returns to normal. The duration of remission depends not only on weather conditions and the microclimate of the room, but also on compliance with preventive recommendations.

The earlier it is possible to recognize the symptoms of erythrasma and interpret them correctly, the more effective its treatment and the more sustainable the result.

Signs of the disease

Externally, erythrasma manifests itself in the form of light brown, brick-red, brown or yellow-brown spots on the skin, most often round in shape and without signs of inflammation. The diameter of the lesions can reach several centimeters, and they tend to merge, forming large affected areas. First of all, erythrasma spots appear in the folds of the skin, where there is a favorable environment for the proliferation of bacteria.

In addition to spots, erythrasma is characterized by:

1. Peeling of the skin on the affected areas, aggravated by touch. Usually this is where the development of the disease begins.
2. Mild, irregular itching. It intensifies and begins to cause significant discomfort only if a secondary infection is added to the primary disease.
3. Absence of fever, wounds, ulcers and ulcers with copious discharge. This distinguishes erythrasma from most bacterial skin pathologies.
4. Getting wet. An optional symptom, the manifestation of which depends on the amount of sweating and the quality of skin care.

It is noteworthy that in children, symptoms of erythrasma appear extremely rarely. The risk group includes adults, primarily men, who are predominantly overweight and prone to excessive sweating. In this case, in men, the skin in the groin, navel and inner thighs is usually affected, and in women, the entire abdomen, armpits and areas under the breasts are affected.

Complications

The main danger of the disease is the risk of complications recorded in patients with hyperhidrosis, diabetes mellitus, obesity and other diseases - the appearance of diaper rash, eczema, vascular disorders, the development of bacterial (streptococcal and staphylococcal) and fungal infections.

Erythrasma in the groin area leads to irritation of the genital organs and the development of secondary infection. The disease is dangerous due to the development of lung abscess, endocarditis, and septicopyemia. The role of Corynebacterium minutissimum in the pathogenesis of male infertility is discussed.

Rice. 9. The photo shows erythematous swelling of the foot in a patient with diabetes mellitus. Multiple blisters and bubbles are visible.

Causes of pathology

Corynebacteria, which are the causative agents of the disease, are normally always present on human skin. Moreover, they provoke the development of pathology only under certain, favorable conditions. Corynebacteria do not penetrate deeper than the epidermis, and also do not affect nails and hair. Since the appearance of erythrasma is directly related to increased sweating, the disease most often manifests itself in the hot summer season.

Among the main reasons for the development of erythrasma are:

• hyperhidrosis;
• deviation of the normal pH of the skin to the alkaline side;
• diaper rash, constant friction and mechanical damage to the skin;
• dermatitis and other skin diseases;
• neglect of personal hygiene rules;
• wearing synthetic, overly warm clothing;
• the use of low-quality care products or the abuse of soap with an antibacterial effect, which destroys the natural protection of the skin.

Erythrasma is transmitted by contact, most often after the use of clothing, bedding and personal hygiene products of the patient. You can also become infected during sexual intercourse, when visiting a pool or bathhouse, and when walking barefoot on the ground or beach. At the same time, it is not always possible to accurately determine the source of infection, because the carrier may not have obvious external manifestations of the disease in the form of characteristic spots and peeling.

Treatment of erythrasma

To diagnose a patient with erythrasma, a dermatologist first uses a visual examination. This is especially true for rashes in the groin area, which have characteristic distinctive features in the form of pronounced protrusions and bubbles along the edges. Also, the affected areas of the skin are illuminated with a Wood's lamp and a microscopic examination of the scraping is performed to exclude other diagnoses: pityriasis versicolor or pityriasis rosea, candidiasis, dermatitis or eczema.

Treatment of erythrasma is primarily based on the use of antibacterial ointments that are used to treat the affected areas of the skin.

Under their influence, corynebacteria die, and the spots gradually lighten, decrease in diameter and disappear. On average, such therapy takes at least 7-10 days. Used in parallel:

1. Antiseptics. Treatment with them is carried out before applying antibacterial ointment, as well as after it, to maintain dryness of the affected areas and prevent re-infection.
2. Antifungal drugs. They are prescribed together with antibacterial drugs, since corynebacteria are similar in structure to fungal micelles.
3. Exfoliating ointments. They help cleanse the skin of a layer of dead cells, activating its regeneration.
4. Ultraviolet irradiation. Promotes skin disinfection and restoration. Patients benefit from both natural sunbathing and physiotherapeutic UV irradiation.

If the disease has not reached an advanced stage, the use of external medications is sufficient to solve the problem. But in some cases, with multiple skin lesions, to obtain the desired result, patients are prescribed systemic antibacterial therapy.

Diagnostics

Diagnosis of erythrasma is based on clinical symptoms and characteristic localization. Confirmed by microscopic examination, which reveals thin, tortuous, septate filaments and coccoid cells located in groups or in chains. Fluorescent diagnostics are widely used: a mercury-quartz lamp with a Wood filter, in the rays of which the lesions fluoresce with coral-red or brick-red light, since the causative agent of the disease releases water-soluble porphyrins during its life. With inguinal epidermophytosis, roller-like edges, a border of macerated epidermis along the periphery of the lesions, blisters, inflammation, and itching are observed.