Erythrasma: a systematic review of interventions

Area of Science:

• Dermatology
• Infectious Diseases
• Bacteriology

Background:

• Erythrasma is a chronic superficial bacterial infection caused by Corynebacterium minutissimum.
• It commonly affects intertriginous areas, presenting with erythema, scaling, and discoloration.
• Characteristic coral-red fluorescence under Wood's lamp aids diagnosis, but treatment consensus is lacking.

Purpose of the Study:

• To assess the efficacy, tolerability, and safety of topical and systemic therapies for erythrasma.
• To provide evidence-based recommendations for erythrasma treatment.
• To identify gaps in current research regarding erythrasma interventions.

Main Methods:

• Searched PubMed and Scopus databases for erythrasma interventions (1971-2020).
• Included humanized randomized controlled trials and clinical studies.
• Assessed complete lesion clearance as the primary outcome, with two reviewers involved in data extraction and quality assessment.

Main Results:

• Twelve articles (6 RCTs, 6 comparative studies) were included, with 8-151 patients.
• Wood's lamp reflection score was a common outcome measure; mycological cure was less frequent.
• Treatment modalities were generally well tolerated, with topical treatments being safer.

Conclusions:

• Both topical clotrimazole and fusidic acid demonstrated efficacy in treating erythrasma.
• Fusidic acid offered faster symptom resolution and fewer side effects compared to clotrimazole.
• Systemic clarithromycin was more effective than erythromycin, despite common gastrointestinal side effects; a need for standardized trials exists.