Summary about Disease
Erysipelas is an acute, superficial bacterial skin infection primarily affecting the upper dermis and superficial lymphatics, characterized by a sharply defined, raised, bright red rash. It's typically caused by group A streptococcus bacteria and often affects the face and legs.
Symptoms
Intensely red, swollen, and sharply demarcated area of skin.
The affected area is usually raised and feels warm and tender to the touch.
The rash typically has a characteristic "orange peel" texture (peau d'orange).
Blisters may form on the affected skin.
Systemic symptoms may include fever, chills, headache, and fatigue.
Swollen lymph nodes near the affected area.
Causes
Group A Streptococcus* bacteria are the most common cause.
The bacteria usually enter through a break in the skin, such as cuts, abrasions, insect bites, surgical incisions, or ulcers.
Conditions like lymphedema, venous insufficiency, eczema, and fungal infections (e.g., athlete's foot) can increase the risk.
Medicine Used
Antibiotics: Penicillin is the first-line treatment. Alternatives include cephalosporins, clindamycin, or erythromycin for penicillin-allergic patients. Oral antibiotics are typically used for mild cases, while intravenous antibiotics are necessary for severe infections or when oral antibiotics are ineffective.
Pain relievers: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain and fever.
Is Communicable
Erysipelas itself is not directly contagious from person to person. However, the bacteria causing it (Streptococcus) can be spread through direct contact with infected skin or droplets. Therefore, good hygiene practices can help prevent the spread of the bacteria.
Precautions
Practice good hygiene, including washing hands frequently with soap and water.
Clean and cover any cuts, scrapes, or wounds promptly.
Keep skin moisturized to prevent cracking and dryness.
Treat underlying conditions that increase the risk of skin breaks, such as athlete's foot or eczema.
Avoid scratching or picking at skin lesions.
How long does an outbreak last?
With appropriate antibiotic treatment, symptoms usually begin to improve within a few days. Complete resolution typically occurs within 1 to 2 weeks. Without treatment, erysipelas can spread and lead to serious complications.
How is it diagnosed?
Clinical Examination: Diagnosis is primarily based on the characteristic appearance of the rash and associated symptoms.
Medical History: The doctor will ask about recent injuries, skin conditions, and other relevant medical history.
Blood Tests: Blood tests may be performed to check for elevated white blood cell count or other signs of infection, especially in severe cases.
Cultures: Rarely, a skin culture may be taken to identify the specific bacteria causing the infection.
Timeline of Symptoms
Initial Stage: A small, red, and slightly swollen area appears on the skin.
Progression: The redness and swelling rapidly spread, and the affected area becomes sharply demarcated and raised. Systemic symptoms like fever and chills may develop. This progression typically occurs over a few hours to a few days.
Treatment Response: With antibiotics, improvement is usually seen within 24-48 hours.
Resolution: The rash gradually fades, and the skin returns to normal over 1-2 weeks.
Important Considerations
Prompt Treatment: Early diagnosis and treatment are crucial to prevent complications such as bacteremia (bloodstream infection), sepsis, abscess formation, and kidney damage (post-streptococcal glomerulonephritis).
Recurrence: Erysipelas can recur, especially in individuals with underlying risk factors like lymphedema. Prophylactic antibiotics may be considered in these cases.
Differentiation from Cellulitis: Erysipelas is a more superficial infection than cellulitis, with a sharply defined border. Cellulitis typically involves deeper tissues and has less distinct borders.
Hospitalization: Severe cases, especially those with systemic symptoms or those occurring in individuals with compromised immune systems, may require hospitalization for intravenous antibiotics and supportive care.