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Erysipelas

Erysipelas is a type of skin infection (cellulitis ).

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)

The infection occurs on the legs most of the time. It may also occur on the face.

Symptoms

  • 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 get rid of the infection. In severe cases, antibiotics may need to be given through an IV (intravenous line).

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

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

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

Other complications include:

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.

References

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.

Millet CR, Halpern AV, Reboli A, et al. Bacterial Diseases. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 74.

Updated: 12/10/2012

Daniel Levy, MD, Infectious Disease, Maryland Family Care, Lutherville, MD. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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