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Erysipelas

What is erysipelas?

Erysipelas is a superficial form of cellulitis, a potentially serious disease. bacterial infection affecting the skin.

Erysipelas affects the upper part dermis and extends to the superficial cutaneous lymphatic. It is also known as the San Antonio fire due to the intense eruption associated with it.

Who gets erysipelas?

Erysipelas most commonly affects infants and the elderly, but it can affect any age group. The risk factors are similar to those for other forms of cellulite. They may include:

  • Previous episodes of erysipelas
  • The skin barrier is broken due to insect bites. ulcers and chronic skin conditions such as psoriasis, athlete's foot, and eczema
  • Current or previous injury (eg, trauma, surgical wounds, radiotherapy)
  • In newborns, exposure to umbilical cable and injury at the vaccination site
  • Nasopharyngeal infection
  • Venous disease (eg, gravitational eczema, leg ulceration) and lymphedema
  • Immunodeficiency or compromise, such as

    • Diabetes
    • Alcoholism
    • Obesity
    • Human immunodeficiency virus (HIV)
  • Nephrotic syndrome
  • The pregnancy

What Causes Erysipelas?

Unlike cellulite, almost all erysipelas is caused by group A beta hemolytic streptococci (Streptococcus pyogenes). Staphylococcus aureus, including methicillin-resistant strains (MRSA), Streptococcus pneumoniae, Klebsiella pneumoniae, Yersinia enterocolitica, and Haemophilus influenzae also rarely cause erysipelas.

What are the clinical features of erysipelas?

The symptoms and signs of erysipelas are usually abrupt and often accompanied by fever, chills, and chills.

Erysipelas predominantly affects the skin of the lower extremities, but when it affects the face, it may have a characteristic butterfly distribution on the cheeks and across the bridge of the nose.

  • The affected skin has a very sharp and raised edge.
  • It is bright red, firm and swollen. You may have fine dimples (like orange skin).
  • It can blister and, in severe cases, it can become necrotic.
  • Bleeding into the skin can cause purple.
  • Cellulite usually does not have such marked swelling, but it shares other characteristics with erysipelas, such as pain and increased heat of the affected skin.
  • In babies, it often occurs in the belly button or diaper / napkin region.
  • Bullous Erysipelas may be due to streptococcal infection or co-infection with Staphylococcus aureus (including MRSA).
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Erysipelas

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What are the complications of erysipelas?

Erysipelas recurs in up to a third of patients due to:

  • Persistence of risk factors.
  • Lymphatic damage (hence impaired drainage of toxins)

Complications are rare but can include:

  • Abscess
  • Gangrene
  • Thrombophlebitis
  • Chronic leg swelling
  • Infections distant from the erysipelas site:
    • Infectious endocarditis (Heart valves)
    • Septic arthritis
    • Bursitis
    • Tendinitis
  • Post-streptococcal glomerulonephritis (a kidney condition that affects children)
  • Cavernous breast thrombosis (dangerous blood clots that can spread to the brain)
  • Streptococcus toxic shock syndrome (rare)

How is erysipelas diagnosed?

Erysipelas is usually diagnosed by the characteristic rash. The erysipelas differential is similar to the mimicry of cellulite. There is often a history of a relevant injury. The tests can reveal:

  • High white blood cell count
  • High C-reactive protein
  • Positive blood culture identifying the organism

Magnetic resonance and Connecticut they are carried out in case of deep infection.

For the skin biopsy findings, see erysipelas pathology.

What is the treatment for erysipelas?

general

  • Cold compresses and pain relievers to relieve local discomfort.
  • Elevation of an infected limb to reduce local inflammation.
  • Compression socks
  • Wound care with saline dressings that are changed frequently

Antibiotics

  • Oral or intravenous penicillin is the first-choice antibiotic.
  • Erythromycin, roxithromycin, or pristinamycin can be used in patients with penicillin. allergy.

  • Vancomycin is used for facial erysipelas caused by MRSA
  • Treatment is generally 10-14 days.

What's the outlook for erysipelas?

While the signs of general illness resolve within a day or two, skin changes can take a few weeks to fully resolve. There are no scars.

Long-term preventive treatment with penicillin is often required to recurrent erysipelas attacks.

Erysipelas recurs in up to a third of patients due to persistent risk factors and also because erysipelas itself can cause lymphatic damage (hence impaired drainage of toxins) in the affected skin that predisposes to attacks additional.

If patients have recurrent attacks, long-term preventive treatment with penicillin may be considered.