Erysipelas

Overview:

Erysipelas is a skin infection that causes painful lesions. Adults and children can be affected, and the lymphatic system is usually involved. The condition is also called Saint Anthony’s Fire, which is a good description of this intense rash. This disease was quite feared in the days before antibiotics, especially in children and infants.

Causes:

Erysipelas is usually caused by a Group A Streptococcus bacteria. It can be brought about by the bacteria gaining entrance through an abrasion, a trauma or some break in the skin. The fiery infection doesn’t seem to need an opening, though, and sometimes there will be no skin break found.

You may have more of a risk for erysipelas if you have ulcers or skin sores, problems that cause your lymph system or veins not to drain properly, or a cut in your skin.

Originally, erysipelas was found most commonly on the face. Now, the legs account for about eighty percent of cases, and the face only about twenty percent. Physicians and dermatologists are unsure why the location of the condition has so radically changed since it was first diagnosed.

Symptoms:

The symptoms of erysipelas include chills, shaking and fever, blisters, sores on the bridge of the nose and cheeks, skin lesions with raised borders, or warm, swollen skin underneath a lesion that is very red and painful. You might experience vomiting or anorexia, or any of the other symptoms before you see the rash – sometimes up to two days before the rash appears. The rash has the consistency like the peel of an orange, a condition also called “peau d’orange”.

A dermatologist can usually determine if you are suffering from erysipelas by checking your skin. Normally, a biopsy is not needed for diagnosis. In earlier years, doctors would inject a saline solution into the rash, pull it back out and culture that to check for bacteria. That method is not commonly in use anymore, since often the bacteria won’t show up in that particular test. If your other symptoms are severe, your physician may draw blood, to be cultured so that sepsis can be ruled out.

Treatments:

Erysipelas is treated by antibiotics like penicillin, erythromycin, clindamycin, cephalosporins or dicloxacillin, which work to eliminate your infection. In cases that are more severe, you may receive antibiotics intravenously. People who experience episodes of erysipelas more than once may need to be placed on antibiotics for a longer time.

As long as your skin is treated promptly, the outcome of erysipelas is usually good. In a few weeks or less, your skin should return to normal. You may experience skin peeling during this time; this is common.

In some erysipelas sufferers, the bacteria can travel into the bloodstream. This results in bacteremia. That infection is capable of spreading to the bones, joints and heart valves. Other complications include possible septic shock. If you have a lesion on the skin that looks like erysipelas, contact your health care provider.

Erysipelas sometimes recurs, in eighteen to thirty percent of all cases. People who have recurring problems with this condition may have a compromised lymphatic or immune system. Since this condition can damage your lymphatic system, the very infection that starts this condition can set itself up for recurrence. Some people who suffer from recurring erysipelas are treated with routine low doses of antibiotics, to help prevent further infections.

The only known preventative for erysipelas is to try to keep your skin healthy, by preventing scrapes and cuts, and keeping your skin moisturized. This can help to reduce your chances of contracting erysipelas.