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Erysipelas

Strep infection - erysipelas; Streptococcal infection - erysipelas; Cellulitis - erysipelas

Erysipelas is a type of skin infection. It affects the outermost layer of the skin and the local lymph nodes. 

Causes

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

Some conditions that can lead to erysipelas are:

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

Symptoms

The infection occurs on the legs or arms most of the time. It may also occur on the face and trunk.

Symptoms of erysipelas may include:

  • Fever and chills 
  • Skin sore with a sharp raised border. As the infection spreads, the skin is painful, very red, swollen, and warm. Blisters on the skin then form.

Exams and Tests

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

Treatment

Antibiotics are used to get rid of the infection. If the infection is severe, antibiotics may need to be given through an intravenous (IV) line.

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

Outlook (Prognosis)

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

Possible Complications

Sometimes the bacteria that cause erysipelas may travel to the blood. This results in a condition called bacteremia. When this happens, the infection may spread to the heart valves, joints, and bones.

Other complications include:

When to Contact a Medical Professional

Call your health care provider if you have a skin sore and other symptoms of erysipelas.

Prevention

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

References

Bryant AE, Stevens DL. Streptococcus pyogenes. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 199.

Patterson JW. Bacterial and rickettsial infections. In: Patterson JW, ed. Weedon's Skin Pathology. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2016:chap 23.

  • Erysipelas on the cheek

    Erysipelas on the cheek - illustration

    Erysipelas produces a rash that is red, slightly swollen, with very defined borders (well demarcated), warm, and tender to the touch. In this photograph, the right cheek is involved. There may be symptoms that affect the entire body (systemic) including fever and chills.

    Erysipelas on the cheek

    illustration

  • Erysipelas on the face

    Erysipelas on the face - illustration

    Erysipelas produces a rash that is red, slightly swollen, very defined (well demarcated), warm, and tender to the touch. This individual has infection in the skin on both sides of the face, however, bilateral (both side) involvement is infrequent. Erysipelas may produce symptoms that affect the entire body (systemic) such as fever and chills.

    Erysipelas on the face

    illustration

    • Erysipelas on the cheek

      Erysipelas on the cheek - illustration

      Erysipelas produces a rash that is red, slightly swollen, with very defined borders (well demarcated), warm, and tender to the touch. In this photograph, the right cheek is involved. There may be symptoms that affect the entire body (systemic) including fever and chills.

      Erysipelas on the cheek

      illustration

    • Erysipelas on the face

      Erysipelas on the face - illustration

      Erysipelas produces a rash that is red, slightly swollen, very defined (well demarcated), warm, and tender to the touch. This individual has infection in the skin on both sides of the face, however, bilateral (both side) involvement is infrequent. Erysipelas may produce symptoms that affect the entire body (systemic) such as fever and chills.

      Erysipelas on the face

      illustration


     

    Review Date: 10/14/2018

    Reviewed By: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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