Interdigital foot infections: Corynebacterium minutissimum and agents of superficial mycoses

The Prevalence and Antibiotics Susceptibility Patterns of Corynebacterium minutissimum Isolates from Skin Lesions of Patients with Suspected Erythrasma from Tabriz, Iran

Erythrasma is a chronic infection of the skin that appears in the body folds as flat copper spots. The causative agent of this infection is Corynebacterium minutissimum (C. minutissimum). Erythrasma can be treated with antiseptics or topical antibiotics. The study aimed to investigate the antibiotics susceptibility patterns, and the presence of the erythromycin resistance gene (ermX and mefA) in C. minutissimum isolates in skin lesions with suspected erythrasma. From July 2020 to May 2022, 278 skin scrub specimens were collected from patients admitted to the hospital of Tabriz University of Medical Sciences. Specimens were incubated on the blood agar plates and isolates were identified by microbiological laboratory methods. The antibiotic susceptibility patterns were determined by the disk diffusion method and resistance genes of ermX and mefA were detected by the PCR method. Out of 278 specimens, 41 C. minutissimum isolates (14.74%) were recovered. The highest frequency of resistance was observed to a penicillin (75.6%) followed by erythromycin and clarithromycin (39.02%), clindamycin (30.05%), tetracycline (24.2%), and gentamicin and neomycin (19.5%). The frequencies of ermX and mefA genes were 75% and 12.5%, respectively. Resistance to antimicrobial drugs was common and worrying. Resistance to erythromycin in C. minutissimum is mainly related to the ermX gene.

Erythrasma in athletes and football players

BACKGROUND

Erythrasma is a superficial skin infection that presents with red-brown, flaky macules. It is caused by the Gram-positive bacteria Corynebacterium minutissimum. The purpose of our study is to investigate the prevalence and incidence of erythrasma in active sportsmen, i.e., athletes and football players, comparing the results with the incidence of the disease in the general population.

METHODS

A total of 140 sportsmen, 110 male athletes and 30 football players, were examined by clinical examination, microscopic examination (Gram staining), and Wood's lamp examination.

RESULTS

Erythrasma was diagnosed in 39% (43) of the athletes and in 40% (12) of the football players studied. Inguinal folds were found to be most commonly affected. The disease was often localized to more than one area. This erythrasma study conducted in Bulgaria is the first in active athletes. The worldwide prevalence of erythrasma in the general population varies from 4 to 15%.

CONCLUSION

It was found that the incidence of erythrasma is high in men actively involved in sports. The results obtained are explained by the presence of many factors predisposing for the development of this disease in the athletes.

Interdigital Pedal Erythrasma treated with one-time dose of oral clarithromycin 1 g: Two case reports

The following are the first detailed cases of Interdigital Pedal Erythrasma successfully treated with a one-time dose of oral clarithromycin 1 g. This is ideal for patients who failed topical therapy or have mechanical or psychosocial restrictions. Treatment provides better compliance, less gastric side effects, and lower treatment costs than oral alternatives.

Characterization of Skin Microbiome in Tinea Pedis

Tinea pedis has been associated with Trichophyton rubrum infection. However, it's not clear whether other microbes were implicated in disease pathogenesis. The composition of microbial communities of patients with tinea pedis and healthy controls were analyzed to identify the characteristics of tinea pedis and differences associated with clinical patterns. We found that microbial community structures were different in patients with tinea pedis compared with healthy controls. Moreover, skin microbiome varied in different forms of tinea pedis. Healthy controls exhibited greater fungal diversity than patients with tinea pedis. In patients with tinea pedis, the dominant bacterial and fungal genera were Staphylococcus and Trichophyton. Compared with healthy controls, Corynebacterium tuberculostearicum was decreased and T. rubrum was increased. C. tuberculostearicum was more abundant in vesicular tinea pedis than in hyperkeratotic and interdigital tinea pedis. Interdigital tinea pedis had a higher detection rate of Corynebacterium minutissimum and T. rubrum than the other forms. These results indicated that bacterial microbes may take part in the development of tinea pedis.

Investigation of Intertriginous Mycotic and Pseudomycotic (Erythrasma) Infections and Their Causative Agents with Emphasize on Clinical Presentations

BACKGROUND

Intertrigo is an erythematous inflammatory condition with multiple etiologies including fungi and bacteria. Intertrigo manifests in different clinical forms with various complaints. This study was conducted to evaluate the causative agents of intertriginous infections with emphasize on clinical presentations.

METHODS

This descriptive cross-sectional study was carried out in 2015-2016, on 188 patients with clinical suspicion of superficial and cutaneous intertriginous infections in Tehran, Iran. Demographic and additional related data were obtained by questionnaire from all participants. Specimens were collected by gentle scraping of the affected areas. Direct examination and culture were performed for all specimens and grown colonies were identified based on the macroscopic and microscopic features. Supplementary tests were done whenever needed. Data were analyzed in SPSS.

RESULTS

Overall, 80 (42.5%) cases with the mean age of 43.5 yr were confirmed for intertrigo. Dermatophytosis was the predominant cause in this study with 36 (45%) cases followed by erythrasma (28 cases, 35%), tinea versicolor (10 cases, 12.5%) and candidiasis (6 cases, 7.5%). Intertrigo lesions with dermatophytic agents significantly were observed in groin in comparison to different infections among body sites (P<0.05). Itching was the most common clinical presentation (57 cases, 71.3%) and also significant association between different infections and clinical manifestations were observed (P<0.05).

CONCLUSION

Different clinical manifestations may be observed in infectious intertrigo. Regarding the significant association observed in this study, some clinical features can be used for presumptive diagnosis of diseases but further studies are required to make it clear.

Epidemiology and fungal species distribution of superficial mycoses in Northeast Brazil

OBJECTIVE

Dermatomycoses are superficial fungal infections which affect the skin, hair and nails of humans and animals. Male and female patients of all ages are affected by this condition. The main etiological agents of dermatomycoses are the dermatophytes fungi of the genera Trichophyton, Microsporum and Epidermophyton, while the main yeasts belong to the genera Candida, Malassezia and Trichosporon. The variation in the distribution of dermatomycoses worldwide justify the conduction of epidemiological studies in order to contribute for the better understanding of patterns of mycological cutaneous infections. This study was conducted from April 2013 to December 2014.

MATERIAL AND METHODS

A total of 205 patients were evaluated, while 235 clinical specimens were obtained. From our positive cases of mycological examination, 73 (64.6%) patients were female, while 40 (35.4%) were male. Scales from the skin and nails were collected and observed at optical microscopy after potassium hydroxide clarification. Cultures were performed on Sabouraud Dextrose Agar added chloramphenicol. Identification was performed by classic methodology.

RESULTS

We found that the glabrous skin was the largest source of dermatomycoses (30.11%), followed by toenails (27.4%) and fingernails (17.7%). Regarding onychomycosis, the most affected population was over 50 years old. Trichophyton rubrum was the dermatophyte fungal species more commonly found. Most of the patients with pityriasis versicolor were adults and female. Another important fact observed is that Candida parapsilosis was the most prevalent species. Finally, a high incidence of T. tonsurans in cases of superficial mycoses was observed.

CONCLUSION

Our results clearly demonstrate peculiarities in terms of etiological agents of dermatophytoses distribution in a specific region of Brazil.

Study of the Etiological Causes of Toe Web Space Lesions in Cairo, Egypt

Background. The etiology of foot intertrigo is varied. Several pathogens and skin conditions might play a role in toe web space lesions. Objective. To identify the possible etiological causes of toe web space lesions. Methods. 100 Egyptian patients were enrolled in this study (72 females and 28 males). Their ages ranged from 18 to 79 years. For every patient, detailed history taking, general and skin examinations, and investigations including Wood's light examination, skin scraping for potassium hydroxide test, skin swabs for bacterial isolation, and skin biopsy all were done. Results. Among the 100 patients, positive Wood's light fluorescence was observed in 24 and positive bacterial growth was observed in 85. With skin biopsy, 52 patients showed features characteristic for eczema, 25 showed features characteristic for fungus, 19 showed features characteristic for callosity, and 3 showed features characteristic for wart while in only 1 patient the features were characteristic for lichen planus. Conclusion. Toe web space lesions are caused by different etiological factors. The most common was interdigital eczema (52%) followed by fungal infection (25%). We suggest that patients who do not respond to antifungals should be reexamined for another primary or secondary dermatologic condition that may resemble interdigital fungal infection.