Corynebacterium-associated skin infections

Abstract

Background: Corynebacterium spp. are diphtheroid bacteria responsible for pitted keratolysis, a common plantar infection confined to the thick stratum corneum.

Aim: To study a series of demographic features of patients suffering from pitted keratolysis, and to present a review of the Corynebacterium-associated infections, including pitted keratolysis, erythrasma, and trichobacteriosis.

Materials and methods: A 2-year, two-center, prospective survey assessed the demographics of pitted keratolysis, including age, gender, site of infection, symptoms, patients' complaints, the use of protective and/or occlusive shoes, seasonality of diagnosis, drug intake, associated skin signs (including dyshidrosis, erythrasma, and trichobacteriosis), recurrences, and previous diagnoses and treatments.

Results: The mean age of the 53 patients with pitted keratolysis was 24.9 years (range, 10-57 years). The male to female ratio was 7.8:1. The soles of both feet were commonly involved (92.4%). Pressure-bearing areas were the usual sites of infection, ranging from restricted involvement of the toes (12/53, 22.6%) to spreading to the entire plantar surface (15/53, 28.3%). A total of 36 (68%) of the 53 patients complained of hyperhidrosis. An unpleasant smell and pain were noted by 35 (66%) and 25 (47%) of the 53 patients, respectively. Occlusive and protective shoes were worn in 51 (96.2%) and 31 (58.4%) of the 53 cases, respectively.

Conclusion: Pitted keratolysis commonly affects young male patients wearing protective shoes for professional reasons, inducing a moist and warm environment. Hyperhidrosis, an unpleasant smell, and pain are the main clinical complaints.