Hi all,
Just doing some reading in prep for the appt wil the new CRS on Jan 3, and I happened across an article that explains why tinactin ot other products containing "azoles" (i.e. miconozole, clotrimazole) might help cure fissures. apparently, a number of bacteria can cause "fissuring" of moist regions on the body. Here is the pertinent paragraph:
Porphyrin-producing coryneform bacteria, which are gram-positive bacilli that constitute part of the normal cutaneous flora, cause a superficial, usually asymptomatic, skin disorder called erythrasma. One particular species, Corynebacterium minutissimum, has often been cited as the sole cause of this infection, but its precise role, if any, remains unclear. The most common site of erythrasma is between the toes, especially in the fourth interdigital space, where it causes fissuring, maceration, and scaling, resembling tinea pedis. Other locations are intertriginous areas, such as the axillae, groin, submammary area, and intergluteal cleft. In these regions, the lesions are usually scaly, brownish-red, sharply circumscribed patches. In hot, humid climates, more extensive disease may occur. The definitive diagnostic technique is examination of the skin with a Wood light, which, because the organisms produce porphyrins, reveals a coral-red fluorescence. Culture of the lesions, which requires special media, is unnecessary. Because they possess some activity against gram-positive bacteria, topical azoles, such as miconazole and clotrimazole, are effective in the treatment of this infection. Topical erythromycin or clindamycin is also effective. Oral erythromycin (250 mg q.i.d. for 2 weeks) is an alternative.25
the azoles are also effectie against the bacteria C. minutissimum and a gram-positive coccus, Micrococcus sedentarius, which live on the skin.