What is Erysipelas?

The incubation period is 2 to 5 days. Prodromal symptoms include sudden fever, chills, discomfort, and nausea. After a few hours to one day, erythema appeared, and it progressively expanded with clear boundaries. The skin temperature of the affected area is high and tense, and there are nodular and non-depressive edema, tenderness and burning pain in the affected area, and the lymph nodes in the guard are usually enlarged with or without lymphadenitis. Pustules, blisters, or small areas of hemorrhagic necrosis may also occur. Occurs on the calf and face.

Wang Aiping	(Chief physician)	Department of Dermatology, Peking University First Hospital

Erysipelas is an infection involving the superficial lymphatic vessels of the dermis. The main pathogen is group A beta hemolytic streptococcus. The predisposing factors are surgical wounds or nostrils, external ear canal, under the ear lobe, fissures between the anus, penis and toes. Any inflammation of the skin, especially those with cleft palate or ulcers, provides a way for pathogenic bacteria to penetrate. Mild abrasions or scratches, injuries other than the head, unclean umbilical cord ligation, vaccination, and chronic leg ulcers can all cause the disease. Pathogenic bacteria can lurk in the lymphatic vessels and cause recurrence.

Western Medicine Name

erysipelas

English name

erysipelas

Affiliated Department

Department of Physiology-Dermatology

Main cause

infection

Clinical manifestations of erysipelas

The incubation period is 2 to 5 days. Prodromal symptoms include sudden fever, chills, discomfort, and nausea. After a few hours to one day, erythema appeared, and it progressively expanded with clear boundaries. The skin temperature of the affected area is high and tense, and there are nodular and non-depressive edema, tenderness and burning pain in the affected area, and the lymph nodes in the guard are usually enlarged with or without lymphadenitis. Pustules, blisters, or small areas of hemorrhagic necrosis may also occur. Occurs on the calf and face.

The recurrence of erysipelas can cause persistent local lymphedema, with the end result of permanent hypertrophic fibrosis, called chronic streptococcal lymphedema. Patients with breast cancer are also vulnerable to repeated erysipelas due to lymphatic stasis after axillary lymph node dissection.

Erysipelas laboratory check

Swab gram staining and bacterial culture of wounds and lesions; blood anti-chain and blood leukocytes; lower extremity erysipelas should undergo mycotic test of toe dander; facial erysipelas should undergo paranasal sinus radiography.

Treatment of erysipelas

1. Systemic treatment: Penicillin is preferred, and the course of treatment is 10-14 days. People who are allergic to penicillin can choose macrolide antibiotics. Patients with recurrent erysipelas during active lymphangiitis are treated with high-dose antibacterial drugs, but they need to be continued in small intermittent doses for a long time to achieve full results.

2. Local treatment: Various antibacterial drugs can be used on the skin surface. Compression therapy can reduce lymphedema and help prevent recurrence. Can be supplemented with physical therapy, such as narrow-wave ultraviolet radiation.

3. Surgical therapy: Persistent rigid edema that is ineffective for the above treatment options, plastic surgery can be recommended.

Erysipelas prevention

Should actively look for skin lesions that can cause pathogenic bacteria to enter, such as scratching, breaking or trauma to eczema, once these skin lesions are found, they should be actively treated. The most common and easily overlooked and untreated susceptibility factor is tinea pedis, which can be a gateway for bacteria to enter the skin. Instruct patients not to dig their noses. ^[1-3]