Erysipelas

Erysipelas. Erysipelas is a non-necrotizing acute dermohypodermitis of streptococcal origin (group A beta-hemolytic streptococcus) that usually affects adults and tends to reoccur. Risk factors recognized by the 2000 Consensus Conference are lymphedema, the existence of a gateway and obesity. Diagnosis is clinical with a classic presentation in the form of a "big red painful leg, acute, febrile and unilateral". Necrotizing fasciitis is the main differential diagnosis, as initial presentation of both may sometimes be similar, but whose severity requires urgent medical and surgical management. Management of erysipelas can be done on an outpatient basis or require hospitalization when parenteral treatment and/or close monitoring is required. Recommended treatment is antibiotherapy with penicillin or macrolides or related in case of allergy, associated with lesions related to skin infection (edema, bubbles) and risk factors (portal of entry and lymphedema) management.