Erysipelas

Definition

Erysipelas is a type of skin infection (cellulitis).

Alternative Names

Causes, incidence, and risk factors

Erysipelas is usually caused by group A Streptococcus bacteria. The condition may affect both children and adults.

Risk factors include:

• A cut in the skin
• Problems with drainage through the veins or lymph system
• Skin sores (ulcers)

In the past, the face was the most common site of infection. Now it accounts for only about 20% of cases. The legs are affected in up to 80% of cases.

Symptoms

• Blisters
• Fever, shaking, and chills
• Painful, very red, swollen, and warm skin underneath the sore (lesion)
• Skin lesion with a raised border
• Sores (erysipelas lesions) on the cheeks and bridge of the nose

Signs and tests

Erysipelas is diagnosed based on how the skin looks. A biopsy of the skin is usually not needed.

Treatment

Antibiotics such as penicillin are used to eliminate the infection. In severe cases, antibiotics may need to be given through an IV (intravenous line).

Those who have repeated episodes of erysipelas may need long-term antibiotics.

Support Groups

Expectations (prognosis)

With treatment, the outcome is good. It may take a few weeks for the skin to return to normal. Peeling is common.

Complications

In some patients, the bacteria may travel to the blood. This results in a condition called bacteremia. The infection may spread to the heart valves, joints, and bones.

Other complications include:

• Return of infection
• Septic shock

Calling your health care provider

Call your health care provider if you have a skin sore (lesion) that looks like erysipelas.

Prevention

Keep your skin healthy by avoiding dry skin and preventing cuts and scrapes. This may reduce the risk for erysipelas.

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References

Habif TP. Bacterial infections. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 9.

Bisno AL, Stevens DL. Streptococcus pyogenes. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 198.