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Flexures
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Erythrasma is caused by an infection with Corynebacterium minutissimum in the flexures. Symmetrical orange-brown scaly plaques spread across the folds. Usually all flexures are involved–axillae, groins, submammary areas and toe webs, although the natal cleft is spared. The condition may be confused with tinea cruris, but the colour is different, more orange-brown, the scale is not just at the edge, the axillae are involved and mycology will be negative. A gram stain on the scales will reveal gram positive rods, and on Wood's light (UVA) examination there is bright pink fluorescence (Fig. 10.25).
Wood’s lamp
Published in Dimitris Rigopoulos, Alexander C. Katoulis, Hyperpigmentation, 2017
Juliano Peruzzo, Clarissa Prieto Herman Reinehr, Tania Cestari
Erythrasma is caused by Corynebacterium minutissimum that grows within the stratum corneum and primarily affects the inguinal, axillary, and submammary folds. Lesions are light coffee color plaques, but can be light red before turning brown. The interdigital spaces of the feet can also be affected, usually with maceration and scaling.15 Examination with WL shows a bright coral-red fluorescence, as a result of porphyrin produced by the bacteria.6,16 For optimal results, affected areas should not be cleaned prior to examination.15 WL is a direct diagnostic tool that permits us to distinguish erythrasma from intertrigo, tinea, or psoriasis inversa.6,16
Differential diagnoses of psoriasis
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
Erythrasma is a common genitocrural infection, especially in males, caused by chronic superficial infection of the skin by Corynebacterium minutissimum, a commensal organism normally found as part of the skin flora.58,59 Typically, irregular erythematous to brown slightly scaly macules with well-defined borders are seen on the upper inner thighs. More chronic lesions can be slightly scaly and lichenified.58,59 Lesions may also be seen in the axillae and the web spaces of the toes. In the inguinal folds, erythrasma may present as an intertrigo and can be macerated and eroded.58,59 It is not usually very itchy, but can be slightly tender.58 It may coexist with T. rubrum and candidosis. Erythrasma can occur at any age but is more common in adults. Warmth and humidity are the ideal predisposing factors. Erythrasma is a clinical diagnosis confirmed by the demonstration of coral pink fluorescence under Wood's light due to porphyrin produced by the bacterium.58
The effect of intravenous ginkgolide on clinical improvement of patients with acute ischemic stroke
Published in Neurological Research, 2020
Yi Dong, Huiqin Li, Qiang Dong
Among the 3652 participants in the post-marketing (phase IV) study, there were a total of 301 drug-related adverse events in 189 patients, an incidence of 5.18%. Severe adverse events occurred in 8 cases (0.22%). In addition to the adverse reactions observed in the pre-marketing group, the post-marketing group also experienced the following adverse events: erythrasma, pruritus, tiredness, chest tightness, palpitation, erythema, maculopapular rash, abnormal liver function, fever and arthralgia. These adverse reactions were mainly mild or moderate and were alleviated after discontinuation of the drug. The frequency, number of cases and incidence of adverse reactions in the post-marketing group are shown in Supplemental Table 2. Interestingly, there is no symptomatic hemorrhagic stroke among 4089 cases.