Erysipelas occurs when bacteria invade the epidermis as a consequence of skin lesions. Patients with eczema or patients who engage in strong physical activities as well as patients with a weakened or systemically impaired immune system are at an increased risk of developing erysipelas. Children younger than six and seniors older than sixty are mostly affected by erysipelas. Furthermore, patients with a history of drug use also face an increased erysipelas risk because of regular injections. Possible other causes for erysipelas include skin ulcers, surgical incisions, insect bites, psoriasis, and edema feet secondary to cardiac insufficiency and diabetes [1] [2].

Erysipelas has been shown to be caused by an infection with the following bacteria: group A / C / D streptococci, Klebsiella pneumonia, Haemophilus influenza, Escherichia coli, and Moraxella. Notably, methicillin-resistant Staphylococcus aureus has also been found in the context of erysipelas [3] [4].

Typical symptoms of erysipelas are a large, elevated, painful erythematous skin patch with sharp borders, blisters, swollen glands, fever, chills and general malaise. Most facial infections are attributed to group A streptococci and usually affect both cheeks and the nose. Erysipelas can also occur after a throat infection with subsequent bacterial migration to the nasal passages [1].

The most common complications of erysipelas include abscess, gangrene, and thrombophlebitis. In selected cases, acute glomerulonephritis, endocarditis, septicemia, and streptococcal toxic shock syndrome may occur. Osteoarticular complications may present as bursitis, osteitis, arthritis, and tendinitis [5] [6].

Classical erysipelas usually does not require elaborate diagnostic workup. However, it is important to distinguish erysipelas from a symptomatically similar type of cellulitis, which does not present with sharp borders with inflammation.

Erysipelas diagnosis is based on a clinical examination of the affected area and an analysis of the patient history. In selected cases, routine blood analysis may be ordered, which commonly reveals an increased erythrocyte sedimentation rate and C-reactive proteins. Standard imaging techniques are usually not necessary for the diagnosis [1] [7].

Bacterial cultures extracted from the infected tissue rarely yield satisfying results. Histological characteristics are dermal edema, vascular dilatation and streptococcal invasion of lymphatics and tissues resulting in an increased presence of neutrophils and mononuclear cells. Bacteria may also infiltrate proximal blood vessels [1].

Erysipelas symptoms can be efficiently countered with cold compresses on the affected skin area, sufficient water intake and fever-reducing measures as well as painkillers.

Surgical removal of erysipelas may be necessary if the infection has led to tissue necrosis. Recurrent erysipelas may occur in around 20% of the patients [8] with potentially disabling disfigurements (e.g. elephantiasis nostras verrucosa).

The mainstay of treatment for erysipelas is antibiotics, typically penicillin or amoxicillin, which are effective against Streptococcus pyogenes. For patients allergic to penicillin, alternative antibiotics such as erythromycin or clindamycin may be used. In addition to antibiotics, supportive care, including rest, elevation of the affected limb, and pain management, is important. Severe cases may require hospitalization and intravenous antibiotics.

With prompt and appropriate treatment, the prognosis for erysipelas is generally good. Most patients respond well to antibiotics, and symptoms improve within a few days. However, if left untreated, erysipelas can lead to complications such as abscess formation, sepsis, or chronic skin changes. Recurrence is possible, especially in individuals with underlying conditions that predispose them to skin infections.

Erysipelas is primarily caused by the bacterium Streptococcus pyogenes, also known as Group A Streptococcus. This bacterium is commonly found on the skin and in the throat. It can enter the skin through minor cuts, abrasions, or insect bites, leading to infection. Factors that increase the risk of erysipelas include compromised immune function, lymphedema, and skin conditions like eczema or athlete's foot.

Erysipelas can affect individuals of all ages but is more common in infants, young children, and older adults. It occurs worldwide, with a higher incidence in temperate climates. The condition is slightly more prevalent in females than males. Recurrence is common, particularly in individuals with predisposing factors such as chronic venous insufficiency or lymphedema.

The pathophysiology of erysipelas involves the invasion of the skin by Streptococcus pyogenes. The bacteria release toxins and enzymes that break down the skin's protective barriers, leading to inflammation and the characteristic rash. The body's immune response to the infection results in the symptoms of redness, swelling, and warmth. The superficial nature of the infection distinguishes erysipelas from deeper skin infections like cellulitis.

Preventing erysipelas involves minimizing risk factors and maintaining good skin hygiene. This includes keeping the skin clean and moisturized, promptly treating any cuts or abrasions, and managing underlying conditions such as eczema or athlete's foot. For individuals with recurrent erysipelas, prophylactic antibiotics may be considered to prevent future episodes.

Erysipelas is a bacterial skin infection caused by Streptococcus pyogenes, characterized by a distinct, raised, red rash. It primarily affects the face and legs and is accompanied by systemic symptoms like fever and chills. Diagnosis is based on clinical presentation, and treatment involves antibiotics and supportive care. With timely intervention, the prognosis is favorable, though recurrence is possible.

Erysipelas is a skin infection that causes a red, swollen, and warm rash, often on the face or legs. It is caused by bacteria and can make you feel unwell with fever and chills. If you notice such symptoms, it's important to see a healthcare provider for diagnosis and treatment. Antibiotics are effective in treating erysipelas, and most people recover well with proper care. Keeping your skin clean and treating any cuts or skin conditions can help prevent it.

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