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Eryththrasma pictures and treatment

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I will look up two things in parallel: representative erythrasma clinical images and evidence based treatment options. Then I will summarize practical treatment steps and include image references.
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erythrasma treatment topical clindamycin erythromycin benzoyl peroxide oral macrolide recurrence prevention

Harrison's Principles of Internal Medicine, Twenty First Edition

Page 4529

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erythrasma clinical photos coral red fluorescence Wood lamp intertriginous lesions

Dermnetnz

Dermnetnz

Page 0

GradeResponse
GradeResponse
Likely you mean erythrasma.

Pictures (what it looks like)

  • Typical lesions are reddish-brown, mildly scaly patches in skin folds (groin, armpits, under breasts, toe webs).
  • On Wood’s lamp, erythrasma shows coral-red fluorescence, which is a key bedside clue (DermNet image set).
Erythrasma Wood lamp coral-red fluorescence
Source: DermNet image catalogue (Wood lamp erythrasma image).

Treatment

According to Harrison’s Principles of Internal Medicine (21st ed., p. 4529), erythrasma responds to:
  • Topical erythromycin
  • Topical clindamycin
  • Topical clarithromycin
  • Topical fusidic acid
  • Oral macrolide therapy for more severe or extensive disease

Practical approach

  1. Localized disease: start with topical antibiotic (for example clindamycin or erythromycin) for about 1-2 weeks.
  2. Extensive/recurrent disease: consider oral macrolide via clinician prescription.
  3. Prevent recurrence:
    • keep folds dry
    • reduce friction/occlusion
    • treat hyperhidrosis if present
    • wash and dry well after sweating
If you want, I can give you a side-by-side table of erythrasma vs fungal rash (tinea/candida) so it is easier to tell them apart.

Gross picture not wood lamp and if lesion is somewhat black then what

Got it.

Gross (daylight) appearance of erythrasma

Without Wood lamp, erythrasma is usually:
  • Well-demarcated patches/plaques in skin folds
  • Color: light brown, reddish-brown, or darker brown
  • Fine scale or wrinkled surface
  • Usually mild itch or no symptoms
So yes, it can look dark brown and in some skin tones can appear very dark, even close to black.

If lesion looks somewhat black, think broader differential

A “black” intertriginous lesion is not always erythrasma. Important possibilities:
  • Tinea (fungal) / mixed infection
  • Post-inflammatory hyperpigmentation after prior rash
  • Acanthosis nigricans (velvety dark thickening, usually symmetric)
  • Confluent and reticulated papillomatosis
  • Fixed drug eruption
  • Melanocytic lesion (nevus/melanoma, especially if asymmetric/irregular)
  • Less common: necrotic or vascular lesions

Red flags needing in-person dermatology review

  • Rapid change in size/color
  • Asymmetry, irregular border, multiple colors
  • Ulceration, bleeding, pain
  • Solitary new very dark patch not fitting typical fold-rash pattern
  • No response to appropriate treatment in 2-4 weeks

Practical next step

If uncertain, do:
  1. Wood lamp (if available)
  2. KOH scraping for fungus
  3. Consider bacterial swab/culture if atypical
  4. Treat based on findings (antibiotic vs antifungal or both if mixed)
If you want, I can give a quick photo-based checklist to separate erythrasma vs tinea vs acanthosis nigricans at bedside.

Yes I need photo only

I can’t provide a new gallery of external photos directly here.
Use this clinical image source for gross (non-Wood lamp) erythrasma photos:
Tip: in that page, look for images labeled erythrasma (groin/axilla/intertriginous brown patches), not Wood lamp images.
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