Erysipelas-Information on Erysipelas

Erysipelas is a skin infection typically caused by group A beta-hemolytic streptococci, although other streptococcal groups are occasionally causative agents. Infection involves the dermis and lymphatics and is a more superficial subcutaneous infection of the skin than cellulitis. Erysipelas is characterized by intense erythema, induration, and a sharply demarcated border, which differentiates it from other skin infections.

Erysipelas may affect both children and adults. The risk factors associated with this infection include a cut in the skin, skin ulcers, and problems with the drainage through the veins or lymph system. In the past, the face was most commonly involved site of infection, yet now accounts for only up to 20% of cases. The legs are affected in up to 80% of cases.

The most common complaints during the acute infection include tenderness of the involved area, fever, chills, and swelling. Death as a direct result of erysipelas is exceedingly rare. Predisposed patients often develop local recurrence, and this can lead to disfiguring and disabling healing reactions, such as elephantiasis nostras verrucosa. This chronic warty, edematous condition is caused by lymphatic destruction from repeated infection.

Erysipelas is most often caused by a specific Streptococcus bacteria known as Group A Streptococcus. In a few cases, it can be caused by other types of Streptococcus or Staphylococcus bacteria. Some cases of erysipelas have an inciting wound such as trauma, an abrasion, or some other break in the skin that precede the fiery infection. However, in most cases, no break in the skin can be found.

Erysipelas predominantly affects the skin of the lower limbs, but when it involves the face it can have a characteristic butterfly distribution on the cheeks and bridge of the nose. Symptoms and signs of erysipelas are usually abrupt in onset and often accompanied by general illness in the form of fevers, chills and shivering. Affected skin is distinguished from other forms of cellulitis by a well-defined, raised border. The affected skin is red, swollen and may be finely dimpled (like an orange skin). It may be blistered. Bleeding into the skin may cause purpura (purple patches). Cellulitis does not usually exhibit such marked swelling but shares other features with erysipelas such as pain and increased warmth of affected skin.

In adults, Group A streptococcal bacterial infection is the most common cause and in children Hemophilus influenza bacterial infection is the most common cause. Treatment for adults is with antibiotics usually a penicillinase – resistant penicillin, cephalosporin, or erythromycin IV or oral depending on the sensitivity. For children less than 3 years old prompt treatment with IV cephalosporins i.e. ceftriaxone is indicated.

infection of the skin and underlying tissue, caused by group A B-hemolytic streptococcus bacteria. Erysipelas causes affected areas of skin to turn bright red and become slightly swollen. The swollen blotches have a distinct border and slowly expand into the surrounding skin. The lesions are most commonly seen on the face, scalp, hands, and legs.

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.