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The erythrasma microorganism in situ: studies using the skin surface biopsy technique.

The skin surface biopsy technique has been used to investigate the erythrasma organism in situ in the stratum corneum in 11 patients. Staining by PAS and Gram stain showed the presence of a large number of organisms arranged haphazardly in some areas and in microcolonies in others. With the scanning electron microscope it was possible to see that smooth filamentous chains of microorganisms had penetrated horn cells and caused disturbance of the surface structure of these cells.Enzyme histochemical tests showed that the erythrasma microorganism possessed a strong reactivity for NAD diaphorase and other mitochondrial enzymes. The reactivity was focal confirming a complex subcellular organization of organelles. It is suggested that the erythrasma microorganism secretes a mucopolysaccharide sheath in some circumstances.

Adult

Tinea pedis and erythrasma in Danish recruits. Clinical signs, prevalence, incidence, and correlation to atopy.

Prior to military service, 665 recruits were examined clinically and microbiologically for tinea pedis and erythrasma and 546 of these were reexamined at the end of military service. The prevalence of clinical signs, erythrasma, and dermatophyte infection at the first investigation was 58.8%, 51.3%, and 6.2%, respectively, and at the second investigation, 81.1%, 77.1%, and 7.0%, respectively. The incidence of tinea pedis was 4.2% during the 9 months of military service. Of those infected at the first visit 41% had persistent infection mainly due to Trichophyton rubrum, whereas new infections were largely caused by Trichophyton mentagrophytes. Some of those persistently infected had signs of chronicity at the follow-up visit, indicating that chronic dermatophytosis may become established in the early twenties. The prevalence of atopy was 15.0% in all the recruits but was almost 50% in those with persistent tinea pedis.

Adolescent

Systemic or local treatment of erythrasma? A comparison between erythromycin tablets and Fucidin cream in general practice.

In a Danish multi-practice study the efficacy of erythromycin tablets (Abboticin 500 mg tablets), fusidic acid cream (Fucidin cream), and placebo was compared in 86 patients (71 men and 15 women) with erythrasma. The patients were treated 'double-blind' for 14 days with either active tablets + placebo cream, placebo tablets + active cream, or placebo tablets + placebo cream. The signs of erythrasma, i.e. colour intensity, demarcation, and scaling of the affected area, as well as degree of fluorescence under Wood's light, were recorded before treatment, after one and two weeks, and at follow-up four weeks later. Cure/improvement was obtained in 77% of the cases in the erythromycin group, 87% in the fusidic acid group, and 42% in the placebo group. There was no difference between the active preparations, whereas both were significantly better than placebo, P = 0.01.

Adolescent

Bifonazole 1% gel in the treatment of superficial dermatophytoses and erythrasma of the feet and groin.

An open, non-comparative study was carried out by four general practitioners into the efficacy and tolerability of a new antifungal preparation, bifonazole 1% gel. The preparation was used once daily to treat clinically diagnosed, superficial dermatophytoses and erythrasma of the feet or groin in 91 patients of which 51 were confirmed by mycological examination. A complete mycological evaluation was available for 28 patients and a cure was recorded in 23 (89%) of these cases. Four patients reported discomfort and burning on application of the preparation and changed to alternative treatments.

Adolescent

[Erythrasma of the nails].

We have studied 17 cases of pseudomycotic onychoses. This condition is frequently seen in the toe nails with the clinical aspect of hyperkeratosis of the nail bed and onycholysis. The Giemsa stained preparations have been performed with the clinical material previously heated in a 40% OHK solution and washed out with distilled water by centrifugation. The microorganism has similar or identical characteristics to those of the agent of erythrasma of the folds. Its morphology and physiological characteristics are comcon to "Corynebacterium" and "Nocardia". It is a gram positive, acid-fast organism with tendency to produce filaments with short lateral branches and fragmentation spores. Indirect inmunofluorescence identifies microorganisms present in the clinical material and that obtained in cultures.

Adolescent

Studies in the epidemiology of tinea pedis. IX. Tinea pedis and erythrasma in new patients at a chiropody clinic.

The feet of 259 new patients at a chiropody clinic were examined for tinea pedis, onychomycosis, and erythrasma: 23% of men and 4% of women were infected by dermatophytes, and the nails of seven males were infected by non-dermatophytes. Of 200 patients examined under Wood's light 37% showed the coral-red fluorescence of erythrasma.Of the 259 patients, 9.7% were infected by Trichophyton interdigitale, 2.7% by T. rubrum, and 1.5% by Epidermophyton floccosum. Reasons are given, based on the method of selection of the patients, for supposing that T. interdigitale is still the dominant cause of tinea pedis in the population at large, despite figures from dermatological clinics suggesting the dominance of T. rubrum. The high incidence of infection in males compared with females corresponds with similar findings in school-children.

Adult

The Auckland skin clinic tinea pedis and erythrasma study.

Three hundred consecutive patients attending the Auckland Hospital dermatology clinic were examined clinically and microbiologically for evidence of interdigital or plantar mycological or bacterial infection. One hundred and nine patients were shown by laboratory investigation to have an infection. Of these, only 89 displayed clinical signs of infection. Erythrasma, a desquamative condition caused by Corynebacterium minutissimum, was the commonest infection in this study. The commonest dermatophyte isolated was Trichophyton mentagrophytes var interdigitale. There was a significant rise in the incidence of both types of infection with age.

Adolescent