Erysipelas

Erysipelas

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Erysipelas is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Cellulitis
  • Saint Anthony's Fire

Disorder Subdivisions

  • None

General Discussion

Erysipelas is an infection of the upper layers of the skin (superficial). The most common cause is group A streptococcal bacteria, especially Streptococcus pyogenes. Erysipelas results in a fiery red rash with raised edges that can easily be distinguished from the skin around it. The affected skin may be warm to the touch. At one time, erysipelas was thought to affect mostly the face, but recent studies suggest that the distribution of the inflammation is changing since at the present time the legs are involved in almost 80% of cases. The rash may also appear on the arms or trunk.



Erysipelas begins with minor trauma, such as a bruise, burn, wound, or incision. When the rash appears on the trunk, arms, or legs, it is usually at the site of a surgical incision or a wound.

Symptoms

Erysipelas usually first appears as a localized lesion that is tender and red. The lesion quickly develops a bright red, shiny color and a spreading, raised border. The typical lesion is so characteristic that its presence is diagnostic. The lesion may feel hot and be painful. There may be accompanying high fever, chills, headache, nausea, and a general feeling of ill health (malaise). The skin in the affected area may resemble the peel of an orange.



In infants, erysipelas may appear on the abdomen due to infection of the umbilical cord. In children and adults, erysipelas most commonly develops on the legs, arms and face. Erysipelas may also develop at sites of minor surgery or trauma, or it may be due to lymphatic obstruction.

Causes

Erysipelas is caused by one of several strains of streptococcus bacteria, or less frequently by a staphylococcus infection. Streptococci are involved in about 80% of cases.

Affected Populations

Erysipelas is a fairly common infection that may affect anyone at any age. It is most common in infants, young children and the elderly, including adults of either sex between ages 60 and 80.

Standard Therapies

Diagnosis

The typical erysipelas lesion is so characteristic that its presence is diagnostic.



Treatment

The treatment of choice is penicillin. For the penicillin-allergic patient, erythromycin or cephalexin may be used.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



The French Erysipelas Study Group, headquartered at a major teaching hospital in Reims, France, reported recently the results of a multi-center, randomized, controlled, clinical trial of a new treatment for erysipelas involving the drug pristinamycin. The group is studying whether pristinamycin might replace oral penicillin as the drug of choice to treat this disorder.



The results of these trials are being debated among clinical researchers interested in the treatment of this disorder.

References

TEXTBOOKS

Beers MH, Berkow R, eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:796.



Berkow R, ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1221.



Champion RH, Burton JL, Ebling FJG. eds. Textbook of Dermatology. 5th ed. Blackwell Scientific Publications. London, UK; 1992:968-72.



REVIEW ARTICLES

Bonnetblanc JM, Bedane C. Erysipela: recognition and management. Am J Clin Dermatol. 2003;4:157-63.



Stulberg DL, Penrod MA, Blatny RA. Common bacterial skin infections. Am Fam Physician. 2002;66:119-24.



Laube S, Farrell AM. Bacterial skin infections in the elderly: diagnosis and treatment. Drugs Aging. 2002;19:331-42.



JOURNAL ARTICLES

Bernard P, Chosidow O, Vaillant L French Erysipelas Group. Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial. BMJ. 2002;325:864.



FROM THE INTERNET

Kotton C. Erysipelas. Medical Encyclopedia. MEDLINEplus. Update Date: 7/19/2002. 2pp.

www.nlm.nih.gov/medlineplus/ency/article/000618.htm



Stanway A. Erysipelas. New Zealand Dermatological Society. Last Updated: 24 April 2002. 2pp.

www.dermnetnz.org/dna.strpt/erys.html



Davis l, Benbenisty K. Erysipelas. emedicine. Last Updated: February 25, 2003. 9pp.

www.emedicine.com/derm/topic129.htm



Morgan JA. Erysipelas. Emergency Medicine Bulletin Board System (EMBBS). nd. 3pp.

www.embbs.com/aem/face-d.html



Moses S. Family Practice Notebook. Last revised 9/6/2003. 4pp.

www.fpnotebook.com/DER24.htm



NIAID. Health Matters. Group A Streptococcal Infections. August 2002. 6pp.

www.niaid.nih.gov/factheets/strep.htm

Resources

Centers for Disease Control and Prevention

1600 Clifton Road NE

Atlanta, GA 30333

Tel: (404)639-3534

Tel: (800)232-4636

TDD: (888)232-6348

Email: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/



NIH/National Institute of Allergy and Infectious Diseases

Office of Communications and Government Relations

6610 Rockledge Drive, MSC 6612

Bethesda, MD 20892-6612

Tel: (301)496-5717

Fax: (301)402-3573

Tel: (866)284-4107

TDD: (800)877-8339

Email: ocpostoffice@niaid.nih.gov

Internet: http://www.niaid.nih.gov/



American Academy of Allergy, Asthma and Immunology

611 East Wells Street

Milwaukee, WI 53202

Tel: (414)272-6071

Fax: (414)276-3349

Tel: (800)822-2762

Email: info@aaaai.org

Internet: http://www.aaaai.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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