Corynebacterium minutissimum is the bacteria that leads to cutaneous eruptions 
of erythrasma and is the most common cause of interdigital foot infections. It 
is found mostly in occluded intertriginous areas such as the axillae, 
inframammary areas, interspaces of the toes, intergluteal and crural folds, and 
is more common in individuals with diabetes mellitus than other clinical 
patients. This organism can be isolated from a cutaneous site along with a 
concurrent dermatophyte or Candida albicans infection. The differential 
diagnosis of erythrasma includes psoriasis, dermatophytosis, candidiasis and 
intertrigo, and methods for differentiating include Wood's light examination and 
bacterial and mycological cultures. Erythromycin 250mg four times daily for 14 
days is the treatment of choice and other antibacterials include tetracycline 
and chloramphenicol; however, the use of chloramphenicol is limited by bone 
marrow suppression potentially leading to neutropenia, agranulocytosis and 
aplastic anaemia. Further studies are needed but clarithromycin may be an 
additional drug for use in the future. Where there is therapeutic failure or 
intertriginous involvement, topical solutions such as clindamycin, Whitfield's 
ointment, sodium fusidate ointment and antibacterial soaps may be required for 
both treatment and prophylaxis. Limited studies on the efficacy of these 
medications exist, however, systemic erythromycin demonstrates cure rates as 
high as 100%. Compared with tetracyclines, systemic erythromycin has greater 
efficacy in patients with involvement of the axillae and groin, and similar 
efficacy for interdigital infections. Whitfield's ointment has equal efficacy to 
systemic erythromycin in the axillae and groin, but shows greater efficacy in 
the interdigital areas and is comparable with 2% sodium fusidate ointment for 
treatment of all areas. Adverse drug effects and potential drug interactions 
need to be considered. No cost-effectiveness data are available but there are 
limited data on cost-related treatment issues. A guideline is proposed for the 
detection, evaluation, treatment and prophylaxis of this cutaneous eruption.