Eritrazma — the chronic pseudo-mycosis of a bacterial origin affecting epidermis mainly in places of large folds of skin. The eritrazma is shown by emergence and merge of the painless gray-brown, brown-red or yellowish-brown spots covered with a small peeling. Diagnostics of an eritrazma is based on her clinical picture, localization of the centers, a typical luminescence at a luminescent research, a characteristic microscopic picture. In treatment of an eritrazma disinfection of linen and clothes has important value. Processing of the centers of defeat, antibiotic treatment, UF-radiation, blood sugar correction, therapy of a gipergidroz is carried out.
Eritrazma received the name thanks to a reddish luminescence of the centers of defeat when performing luminescent diagnostics. In translation from Greek the word "eritrazm" means red coloring. The disease occurs generally at adults, is more often among males and is characterized by a long current without any negative subjective feelings.
The long time an eritrazma along with actinomycosis, otrubevidny is deprived, a trichophytia, favusy, an epidermofitiya and a microsporia considered a fungal disease of skin. It was connected with the fact that the microscopy of the scales taken from the sites struck eritrazmy skin revealed availability of the twisting thin threads reminding a mycelium. In modern dermatology the eritrazma is carried to pseudo-mycoses — diseases on a clinical picture similar to fungal damage of skin, but at the same time having absolutely other etiology.
Causes of an eritrazma
The activator of an eritrazma Corynebacterium minutissimum belongs to korinebakteriya. It has insignificant pathogenicity and low contageousness and normal is on the surface of skin of healthy people as a saprofitny microorganism. Transmission of infection happens in the contact way through personal care products, at sexual contact, visit of a bath or the pool, during circulation barefoot on the ground or on the beach.
The activator of an eritrazma strikes only a blanket of skin (epidermis), hair and nails remain intact. Penetration of a bacterium into epidermis with development of an eritrazma can be promoted and change skin in the alkaline party, a hot and humid climate, friction and maceration of skin (traumatic dermatitis), by an intertrigo, specific features of a macroorganism, bad respect for hygiene of skin or, on the contrary, too frequent washing with soap breaking natural protective properties of skin.
Eritrazma begins with emergence on the surface of skin of roundish not inflammatory spots of light brown, brick-red, brownish or yellowy-brown coloring. Diameter of spots can be small or reach several centimeters. Spots at an eritrazma have roundish edges more often, but can be and scalloped. Increasing in sizes, the centers of defeat begin to merge forming the uniform large site of an eritrazma which is accurately delimited from healthy skin. It has a smooth surface and is covered with small otrubevidny scales. Over time in the central part of the site struck eritrazmy brown pigmentation or pobledneny colourings is noted.
Characteristic localization of an eritrazma is skin of large folds. At men defeat of inguinal area, the internal surface of hips, and also skin around an anus is most often observed. At women of an eritrazm proceeds pleated under mammary glands, on skin of okolopupochny and axillary areas more often. At stout persons defeat of folds on a stomach is possible.
Usually the eritrazma is not followed by any subjective feelings. Only in certain cases patients note a small itch. Because of this eritrazm long time can imperceptibly proceed and not be the cause for the address to the dermatologist. Eritrazma proceeds is long (more than 10 years) and is followed by alternation of the periods of remission and an aggravation. Eritrazma aggravations usually arise during the summer period when warm weather promotes bigger reproduction of bacteria. At patients with obesity, gipergidrozy, diabetes of an eritrazm can accept the complicated current with accession of symptoms of eczema, emergence of an intertrigo or secondary infection of the center of defeat. Development of complications is also promoted by friction, the increased humidity and impurity of the site struck eritrazmy skin. Emergence of burning, an itch and/or morbidity in the field of defeat is characteristic of the complicated eritrazma.
Diagnostics of an eritrazma
Its typical clinic and arrangement of sites of defeat, characteristic red and coral or red and brick luminescence when carrying out a luminescent research allows to diagnose an eritrazma Wood's lamp. Luminescent diagnostics has to be carried out on the raw site of an eritrazma as washing or processing can wash away the pigment allocated by bacteria. The microscopy of the scrape taken from the site struck eritrazmy skin reveals the twisting threads and kokkovidny cages, similar to a mycelium, forming chains or separate groups.
Differentiate an eritrazma from an inguinal epidermofitiya, multi-colored depriving, a rubromikoza, pink depriving, candidiasis of skin, microbic eczema, perianalny dermatitis. In difficult cases for an eritrazma differentiation from other diseases carry out scrape on nutrient mediums for identification of the activator. Definition of sensitivity of the activator to antibacterial medicines is necessary at the choice of medicine for system antibiotic treatment.
Treatment of an eritrazma
Local treatment of an eritrazma consists in rubbing in in the field of defeat of eritromitsinovy or sulfur-tar ointment. The procedure is carried out by 2 times a day within a week. After this spot of an eritrazma remain still some time, and then gradually turn pale and disappear. At accession of a secondary infection and emergence of inflammatory changes in the centers of defeat they are in addition processed rezortsinovy alcohol or aniline dyes. Bolshaya Square of the centers of defeat at an eritrazma is the indication for performing system antibiotic treatment.
The drying and disinfecting action of soft ultraviolet rays favors to the fastest permission of the centers of an eritrazma and prevents emergence of exacerbations of a disease. Therefore it is useful for patients is in the sun in morning and evening hours, and also to undergo procedures of local Ural federal district. For the prevention of self-infection and successful treatment of an eritrazma it is necessary to carry out disinfection of clothes, footwear, personal objects and bed linen of the diseased. It is necessary to wash things and clothes daily and to iron surely the iron.
In complex treatment of an eritrazma at patients with diabetes consultation of the endocrinologist is necessary for correction of level of sugar of blood. To patients with the increased perspiration during remission of an eritrazma effective treatment of a gipergidroz has to be carried out: simpatektomiya, ultrasonic destruction, curettage or surgical excision of sweat glands of problem area.
Prevention of an eritrazma
Primary prevention of an eritrazma includes respect for hygiene of integuments, careful drying of skin in large folds after a shower or a bathroom, refusal of wearing too close clothes and linen from synthetic fabrics, fight against excess weight and the increased perspiration (deodorants, antiperspirants, a mesotherapy botulotoksiny).
The secondary prevention directed to the prevention of a recurrence of an eritrazma is carried out within a month after disappearance of symptoms of a disease and consists in processing of skin folds camphor or salicylic alcohol with the subsequent putting talc.