Introduction:
Cutaneous is a medical term that refers to skin. Diphtheria is a life-threatening infection induced by Corynebacterium diphtheriae strains that produce a toxin. It may potentially cause death as it disrupts the normal rhythm of the heart and makes breathing difficult. Diphtheria is of two types: respiratory and cutaneous. The term cutaneous diphtheria refers to the type of diphtheria that primarily manifests on the skin. Corynebacterium diphtheriae, the same bacterium that is responsible for respiratory diphtheria, is the culprit behind this unprecedented bacterial contamination. This article will provide an overview of cutaneous diphtheria, including its causes, symptoms, diagnosis, treatment, and preventative measures.
What Is Cutaneous Diphtheria?
Cutaneous diphtheria is a type of diphtheria that causes infections and inflammation of the skin. It happens when the bacteria C. Diphtheriae gets into a wound in the skin and causes sores or ulcers. The presence of a grayish membrane resembling that of diphtheria distinguishes this disease from other skin infections. Interestingly, this cutaneous form of diphtheria is frequently observed in tropical nations. Unlike respiratory diphtheria, which can pose a potential risk to life, a cutaneous form of diphtheria hardly causes any serious illness.
What Is the Cause of Cutaneous Diphtheria?
The bacterium known as Corynebacterium diphtheriae is responsible for the development of cutaneous diphtheria. The microorganism can be detected in the nose, throat, and skin of affected individuals. This microorganism can get into the body through cuts, scrapes, or other skin openings when it comes into direct contact with the skin or infected objects. This is the underlying cause of cutaneous diphtheria.
Who Is at the Risk of Contracting Cutaneous Diphtheria?
Temperate climates are more likely to see cases of this kind of diphtheria. It most commonly manifests itself in tropical regions that are home to an endemic population of C. diphtheria, such as Asia, Africa, and the southern part of the Pacific Ocean. The region is often known as the Middle East, the Caribbean, and the Southern United States.
In developed nations, cutaneous diphtheria most frequently manifests itself in unvaccinated people who have recently returned from an endemic region or in people who have gotten the disease from domesticated pets or wild animals.
There have been reports of outbreaks of cutaneous diphtheria in underprivileged communities that are overpopulated and have limited access to sanitary facilities as well as medical care.
Direct contact with infected skin or bandages that are contaminated is thought to be the mode of transmission for the C. diphtheriae bacteria. People have also contracted cutaneous diphtheria after getting traditional tattoos.
What Does Skin Diphtheria Look Like?
Cutaneous diphtheria usually starts as a small blister or pimple, which quickly breaks down and forms a shallow ulcer with a distinct raised edge. These ulcers can be solitary or multiple and can vary in size from a few millimeters to several centimeters. The most commonly affected areas are the hands, feet, and legs. Initially, the ulcers can be painful, but over time, they become painless. As the ulcer deepens, a grayish-brown membrane forms at the base and the surrounding skin may appear pink to purple, swollen, and blistered. The lymph nodes in the nearby area may also become enlarged.
The ulcers caused by cutaneous diphtheria usually heal on their own within two to three months, but they may leave depressed scars. In many cases, the infection occurs after a minor injury to the skin, such as a scrape or insect bite. It can also develop in people with pre-existing skin conditions like dermatitis or scabies.
Is Cutaneous Diphtheria Painful?
Skin wounds caused by cutaneous diphtheria are identifiable by a scaling rash, open sores, or blisters, and they can manifest themselves anywhere on the body. These skin wounds can cause pain, swelling, and a reddening of the skin. Therefore, cutaneous diphtheria might be painful.
How Is Cutaneous Diphtheria Spread?
Cutaneous diphtheria is a highly contagious illness. Cutaneous diphtheria is mostly spread through direct contact with an infected person (both men and women). The transmission of diphtheria from one individual to another can occur through either indirect or direct contact with infected skin lesions. There is also evidence that transmission can take place in housing situations that are overcrowded and lacking in sanitation.
How Long Does an Infected Person Have the Ability to Transmit the Bacteria?
In the absence of medical treatment, the infectious period typically lasts for less than two weeks. When someone is given antibiotics, the period of time during which they are contagious is reduced to less than four days; nevertheless, in extremely rare cases, persistent carriers may continue for up to six months. When two cultures of the skin lesions are taken 24 hours apart, not less than 24 hours after finishing antimicrobial treatment, and both come back negative, the infection is no longer contagious and can no longer be spread.
How to Diagnose Cutaneous Diphtheria?
Identifying cutaneous diphtheria can be challenging, as it can resemble other skin infections caused by different germs. This is particularly true in developed countries, where cutaneous diphtheria is relatively rare. The cutaneous form of diphtheria should be suspected in patients who have an ulcer that does not heal, particularly if they have recently traveled to an endemic region. A bacterial wound swab can be used to grow Clostridium diphtheriae or Clostridium ulcerans.
How Is Cutaneous Diphtheria Treated?
The treatment for the skin infection consists of thoroughly washing the affected area with antibacterial soap and water, as well as taking the prescribed medications. The medications include antibiotics such as Erythromycin at a dosage of 40 mg/kg/day (with a daily maximum of 2 g) for a period of 14 days.
Patients who have membranous ulcers larger than 0.79 inches and patients who have systemic toxigenic symptoms should be isolated to prevent the disease from spreading further. An antitoxin that can counteract the toxigenic effects on the system may also be investigated.
After a treatment period of 48 hours with the appropriate antibiotics, cases are no longer infectious.
How Can Cutaneous Diphtheria Be Prevented?
For the prevention of cutaneous diphtheria, vaccination is absolutely necessary in order to increase herd immunity and lessen the likelihood that C. diphtheriae will be passed on. It is likewise crucial to maintain good hand hygiene, keep away from sharing personal items, and adhere to respiratory hygiene practices to reduce the chance of transmission.
Conclusion:
Cutaneous diphtheria is extremely uncommon and manifests as a rash, lesions, or blisters on the skin anywhere on the body. In tropical regions or densely populated areas where people live in unsanitary conditions, cutaneous diphtheria is more likely to occur. The best mode of prevention is getting vaccinated and maintaining a sanitary environment.
