Saturday, January 8, 2011

Eritrasma

Eritrasma Eritrasma is a chronic superficial infection of the intertriginous areas of skin. Corynebacterium minutissimum body in question was a common body of human skin. Eritrasmei incidence is reported to be 4%. Infection is seen worldwide, most commonly in tropical and subtropical areas of the globe.
Eritrasma is usually a benign pathological condition. However, it may become extensive and invasive and prone to immunocompromised persons. It is very rare in immunocompetent hosts. On susceptible hosts, and other infections cause the body than eritrasma. These include the formation of abscesses, infections associated with intravascular catheterization, primary bacteremia, catheterisation associated peritoneal infection, endocarditis and pileonefrita. The patient shows the underarms, groin, submamara, subfesiera dark colored areas, itchy. The skin is wrinkled with fine scales. The skin fold angle is observed skin maceration.
Treatment using antifungal agents to eradicate the organism. It can be treated with topical or systemic erythromycin. The body is sensitive and I generation cephalosporins, clindamycin, tetracycline and vancomycin. The prognosis is excellent condition, however, tends to return if predisposing factors are eliminated.
Pathogenesis and causes
Corynebateria invades the top layer of the epidermis, the stratum corneum under favorable conditions such as heat and humidity, proliferate. Stratum corneum is thickened. Intracellular organisms are seen in places like cells, dissolved keratin fibrils. Coral red fluorescence seen at the Wood lamp illumination is secondary to the production of porphyrins by these difteroizi.
Causes Corynebacterium minutissimum is a member of the bacterial flora of the skin. Is lipophilic bacteria, gram-positive, do not form spores, aerobic and catalase-positive. Ferment glucose, deztroza, sucrose, maltose and mannitol.
Predisposing factors include the following: Excezive-sweating and hyperhidrosis, delicate cutaneous barrier -Obesity, diabetes, hot climate, -Poor hygiene, old age, other immunodeficiency states.
Signs and symptoms of eritrasma
Eritrasmei incidence increases with age, but no age group is immune to the disease. The youngest patient was a child of one year. The patient shows dark discoloration of the skin affected the natural folds of skin that are moist and dark. The infection is usually asymptomatic, but may be itchy. The duration is from several months to several years. It is possible to spread on the trunk and limbs.
Physical Exam Physical appearance is typical of well-demarcated red-brown patches. Looks wrinkled skin with fine scales. The infection is often localized inguinal, axillary, crural, scrotum and between toes. Armpit area submamara, umbilical region and are less involved intergluteal space. Interdigital lesions shows maceration. Eritrasma is usually a benign pathological condition. However, it may become extensive and invasive and prone to immunocompromised persons. is very rare in immunocompetent hosts. On susceptible hosts, and other infections cause the body than eritrasma. These include the formation of abscesses, infections associated with intravascular catheterization, primary bacteremia, catheterisation associated peritoneal infection, endocarditis and pileonefrita
Diagnosis Eritrasma
Laboratory studies: Wood-lamp examination shows a coral-red fluorescence of the lesions, the exam may be negative if the patient has previously bathed Cram-stain showed gram-positive cocci filamentous.
Histological examination. Difeteroida bacterium is present in the stratum corneum in the form of filaments and cocci.
The differential diagnosis is made with the following conditions: acanthosis nigricans, cutaneous candidiasis, contact dermatitis, allergic, irritating, intertrogo, psoriasis, seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis.
Treatment Eritrasma
Pharmacotherapy reduce morbidity, prevent complications of infection and destroy. Antifungal and antibacterial agents are used to eradicate Corynebacterium minutissimum and possible co-infections. Erythromycin is the standard treatment. Infection can be treated with topical or oral agents. Therapy must be comprehensive and cover most pathogens involved in these clinical pictures. Corynebacterium minutissimum is sensitive to penicillins, cephalosporins I generation, erythromycin, clindamycin, ciprofloxacin, tetracycline and vancomycin. However, resistant strains were isolated.
Prognosis. Complications include septicemia fatal to immunocompromised patients, infective endocarditis in valvular heart disease, postsurgical wound infections. The prognosis is excellent condition, however, tends to return if predisposing factors are eliminated. Patients should be instructed to keep the affected area dry.

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