Erythrasma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Erythrasma develops when Corynebacterium minitissium infiltrates the stratum corneum and proliferates. Hyperkeratosis leads to the formation of reddish-brown lesions characteristic of erythrasma. Microscopic pathology of erythrasma includes thickening of stratum corneum, decreased electron density around intracellular bacteria and those in direct contact with the cell wall, and widening of intracelluar space, allowing bacterial invasion, and separation of the horny cells. Erythrasma is associated with dermatological conditions, including additional corynebacterium pathologies.
Pathophysiology
Pathogenesis
- Erythrasma develops when Corynebacterium minitissium infiltrates the stratum corneum and proliferates.[1]
- The bacteria proliferates on the epidermis and develops at the intracellular level of the stratum corneum.
- Penetration of the skin occurs when the horny cells of the plasma membranes rupture.
- Keratolysis occurs due to the removal of keratin fibrils from the bacteria.
- The exact cause, chemical or systemic, of the keratolysis is unknown.[2]
- Hyperkeratosis leads to the formation of reddish-brown lesions characteristic of erythrasma.[3]
Microscopic Pathology
- Erythrasma presents with the following microscopic findings:[1]
- Thickening of stratum corneum without signs of parakeratosis
- Largest concentration of Corynebacterium minitissium in the upper third of the stratum corneum
- Widening of intracelluar space, allowing bacterial invasion, and separation of the horny cells
- Disappearance of plasma cell membranes at the sites of Corynebacterium minitissium infiltration.
- Decreased electron density around intracellular bacteria and those in direct contact with the cell wall
Associated Conditions
Erythrasma is associated with the following dermatological conditions:
- Other cornyebacterium-infection pathologies:[4]
- Pitted keratolysis
- Trichobacteriosis
- Tinea pedis
- Tinea versicolor[5]
- Intertrigo[6]
- Psoriasis[7]
- Dermatophytosis
- Candidiasis
References
- ↑ 1.0 1.1 Montes, Leopoldo F.; Black, S.H.; McBride, Mollie E. (1967). "Bacterial Invasion of the Stratum Corneum in Erythrasma". Journal of Investigative Dermatology. 49 (5): 474–485. doi:10.1038/jid.1967.168. ISSN 0022-202X.
- ↑ Raubitschek, F. (1962). "Mechanical versus chemical keratolysis by dermatophytes". Medical Mycology. 1 (2): 87–90. doi:10.1080/00362176285190191. ISSN 1369-3786.
- ↑ Montes LF, McBride ME, Johnson WP, Owens DW, Knox JM (1965). "Ultrastructural study of the host-bacterium relationship in erythrasma". J. Bacteriol. 90 (5): 1489–91. PMC 315839. PMID 5848336.
- ↑ Pinto M, Hundi GK, Bhat RM, Bala NK, Dandekeri S, Martis J, Kambil SM (2016). "Clinical and epidemiological features of coryneform skin infections at a tertiary hospital". Indian Dermatol Online J. 7 (3): 168–73. doi:10.4103/2229-5178.182351. PMC 4886587. PMID 27294050.
- ↑ Whittle CH (1932). "Tinea Versicolor of the Trunk and Groins Simulating Erythrasma". Proc. R. Soc. Med. 25 (8): 1318–9. PMC 2184180. PMID 19988837.
- ↑ Kalra MG, Higgins KE, Kinney BS (2014). "Intertrigo and secondary skin infections". Am Fam Physician. 89 (7): 569–73. PMID 24695603.
- ↑ Holdiness MR (2002). "Management of cutaneous erythrasma". Drugs. 62 (8): 1131–41. PMID 12010076.