Erythrasma

Erythrasma is a superficial bacterial infection of skin folds that mimics tinea cruris. Caused by Corynebacterium minutissimum, this medically insignificant disease occurs primarily in men.

Usually, erythrasma is asymptomatic. Morphologically, it is characterized by well-demarcated, pink/tan, lightly scaling, or slightly crinkled plaques that, in the

Table 12 Necrotizing Fasciitis

Clinical

Differential

Diagnosis

Symptoms

appearance

diagnosis

Treatment

Necrotizing

Severe pain

Erythema,

Cellulitis,

Early diagnosis,

fasciitis (deep

disproportion-

swelling,

erysipelas,

resuscitation,

necrotizing

ate to local

blisters and

brown recluse

surgical

soft-tissue

findings, sys-

hemorrhagic

spider bite,

debridement,

infection)

temic shock

bullae,

bullous

broad-

indistinct

pyoderma

spectrum

margins

gangrenosum

antibiotics, with or without hyperbaric oxygen to affected tissues

Vulva Disease

genital area, occur on the proximal, medial thighs with sparing of the vulva proper (Fig. 14). Unlike tinea cruris, there is no accentuation of peripheral scale, and a microscopic examination of scrapings of the stratum corneum does not show fungal elements.

The differential diagnosis includes, in addition to tinea cruris, lichen simplex chronicus (eczema/localized atopic dermatitis) and psoriasis. The diagnosis is made by the absence of fungal elements on a microscopic examination, or by illumination with a Wood's lamp, which produces a coral fluorescent color. The diagnosis is confirmed by response to therapy.

The treatment of erythrasma consists of erythromycin, either oral (500 mg) or topical application twice daily for one or two weeks, but topical erythromycin has the higher cure rate in the groin (40). Recurrence is common and chronic therapy is sometimes required (Table 13).

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