Diphtheria cutaneous

Synonym(s)

None

Definition

Acute, toxin-mediated disease caused by Corynebacterium diphtheriae

Pathogenesis

C. diphtheriae (causative organism) an aerobic, toxin-producing, gram-positive bacillus; toxin production only when the bacillus infected by a specific virus carrying the genetic information for the toxin; only toxi-genic strains cause severe disease; toxin inhibiting cellular protein synthesis responsible for local tissue destruction and membrane formation; toxin produced at the site of the membrane absorbed into the bloodstream and disseminated

Clinical manifestation

Skin findings: seen mainly in homeless persons; erythematous scaling plaques; ulcers with an overlying membrane and demarcated edges; mucous membranes sometimes involved

Differential diagnosis

Other bacterial pyodermas; erythema multiforme; tropical ulcer; pyoderma gan-grenosum; Majocchi's granuloma; atypical mycobacterial infection; nocardiosis; aspergillosis; syphilis; granuloma inguinale; chancroid

Therapy

Erythromycin; procaine penicillin G; diphtheria antitoxin 20,000-50,000 units IM*

References

Efstratiou A, Roure C (2000) The European Laboratory Working Group on diphtheria: A global microbiologic network. Journal of Infectious Diseases 181 Suppl 1:S146-151

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