Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1C44

By Baerensprung 1862.

Baerensprung's disease.

Superficial infection with the gram-positive, aerobic Bacillius corynebacterium minutissimum.

  • Prevalence: 4-6% of the total population in Central Europe, higher prevalence in tropical zones
  • Older studies from England and New Zealand put the prevalence at around 20%
  • Rarely seen in children
  • Frequently seen in healthy patients
  • Predisposing factors:
    • Male gender
    • Diabetes mellitus
    • Older age
    • Immunosuppression
    • Overweight
    • Hyperhidrosis
    • High humidity
    • Warm environment
    • Poor hygiene

  • Pathogen: Corynebacterium minutissimum, which produces porphyrin. Wood's light shows a red fluorescence
  • The bacteria penetrate the upper stratum corneum through skin defects

  • Up to 10.0 cm in size, sharply circumscribed macules, sometimes confluent, often pruritic reddish-brown, and later plaques with fine lamellar scaling. The itching is favoured by sweating and prolonged sitting. The disease is often associated with bromhidrosis, keratoma sulcatum and trichobacteriosis axillaris
  • In the interdigital spaces of the toes, corynebacteria are the most common cause of bacterial infections. Interdigital mycosis may also exist at the same time
  • The discoid form is not limited to the intertriginous areas. Discoid erythrasma is more common in women with black skin in tropical latitudes
  • When erythrasma occurs in the genital or anal area, the latter often develops chronic pruritus

  • Clinic
  • Wood light examination: coral red fluorescence (Pat. should not have bathed shortly before, as the porphyrins are water-soluble. The test would be falsely negative in this case.)
  • Detection of pathogens using the tear-off method with adhesive tape
  • No Gram stain, culture or biopsy necessary
  • KOH e.g. of a tinea interdigitalis
  • HIV test

Intertrigines (groin, axilla, anal, abdominal crease, submammary, great labia, scrotum, thigh and interdigital space).

  • The bacteria can often be detected in the stratum corneum. In addition, a discrete perivascular infiltrate
  • is seen
  • Culture (possible, but not necessary for diagnosis)

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  4. Holdiness MR. Management of cutaneous erythrasma. Drugs 2002;62:1131-41.
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  7. Macmillan AL, Sarkany I. SPECIFIC TOPICAL THEEAPY FOR ERYTHRASMA. Br J Dermatol 1970;82:507-9.
  8. Rho N-K, Kim B-J. A corynebacterial triad: Prevalence of erythrasma and trichomycosis axillaris in soldiers with pitted keratolysis. Journal of the American Academy of Dermatology 2008;58:S57-S8.