Skin | Dermatology | Erysipelas (Disease)
Erysipelas is an infection that may occur on any part of the skin including the face, arms, fingers, legs and toes, but it tends to favor the extremities. Fat tissue is most susceptible to infection, and facial areas typically around the eyes, ears, and cheeks.
Patients typically develop symptoms including high fevers, shaking, chills, fatigue, headaches, vomiting, and general illness within 48 hours of the initial infection. The erythematous skin lesion enlarges rapidly and has a sharply demarcated raised edge. It appears as a red, swollen, warm, hardened and painful rash, similar in consistency to an orange peel. More severe infections can result in vesicles, bullae, and petechiae, with possible skin necrosis. Lymph nodes may be swollen, and lymphedema may occur. Occasionally, a red streak extending to the lymph node can be seen.
Causes and Risk factors
Erysipelas is an infection caused by the group A Streptococcus bacteria involving the skin. It can affect children and adults. A cut in the skin, lymph drainage problems, and skin ulcers increase the risk of infection. 20% of cases involve the face.
This disease is most common among the elderly, infants, and children. People with immune deficiency, diabetes, alcoholism, skin ulceration, fungal infections and impaired lymphatic drainage (e. g. , after mastectomy, pelvic surgery, bypass grafting) are also at increased risk.
Repeated infection of the extremities can lead to chronic swelling (lymphadenitis).
Erysipelas: Treatment and Diagnosis
Therapy depends on the severity of illness. Some patients can be treated with oral antibiotics and as outpatients while others need close monitoring and intravenous medications. The medications commonly used include: penicillin, cephelexin (Keflex), azithromcin (Z-Pac), or erythromycin