Erysipelas

What is Erysipelas?

Erysipelas is a bacterial infection involving the deep dermis (second layer of skin) and subcutaneous tissue (fat). Erysipelas is primarily an infection of the dermis. It is most often caused by streptococcus pyogenes.

Who is at risk for Erysipelas?

This is a disease of the very young, the aged, the debilitated, and those with lymphedema or chronic cutaneous ulcers. A female predominance exists, except in young patients, where it is more commonly seen in boys. There is increased frequency during the summer months. Most cases are isolated.

What causes Erysipelas?

Most cases of erysipelas are caused by bacterial infection with Group A Strep, and less often by groups G, B, C, and D streptococci.

What are the signs and symptoms of Erysipelas?

Classically erysipelas, with its well-defined margins, involves the face. The lower legs are now the most common location. The incubation period ranges from 2 to 5 days. It is characterized by an abrupt onset of fever, chills, and nausea. A few hours to a day after these symptoms, a small plaque of redness develops that progressively spreads. The area is clearly demarcated from uninvolved tissue, hot, tense, indurated, and demonstrates swelling that does not leave a mark when pressure is applied to it. The affected area is painful to palpation and may burn. Lymph nodes are typically swollen in this area, with or without lymphatic streaking. Pustules and large and small blisters may form as well.

What are the complications of Erysipelas?

Complications are and usually occur in patients with underlying diseases. When the infection resolves, sloughing of the skin and post inflammatory pigmentary (scarring with darkened color) changes may occur.

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