Erysipelas is a serious inflammation of the skin and subcutaneous fat tissue, caused by bacteria. The condition occurs when bacteria penetrate the damaged skin. The skin around the wound is (shiny) red and sore. Erysipelas is most common on the leg, arm or face.
Cause
The infection is usually caused by streptococci and sometimes by staphylococci bacteria. These bacteria are naturally already found on the skin, but are harmless then. A person can catch erysipelas when the bacteria enter the skin through a wound. After infection, it takes one to two days before the first symptoms occur. Erysipelas is most common on the legs (often via wounds at the feet), but the condition can also occur on the arms and in the face.
Erysipelas is generally not contagious from person to person. The bacterium that causes erysipelas is very common, but only people with poor immune systems are getting ill. Children, the elderly, diabetics and cardiac patients are at risk to have erysipelas.
Symptoms
Erysipelas is often preceded by one or two days of fatigue, lethargy or not feeling well. Next, the affected skin becomes red, hot and swollen. Sometimes there are vesicles visible of various sizes. The infected area hurts. The border of erysipelas to healthy tissue is clearly visible. Erysipelas is often accompanied by fever and chills. A patient can feel very sick.
In severe cases of erysipelas or when it isn’t treated quickly, complications can occur. For example, the infection can penetrate deeper into the tissue and affect the muscles. The lymph nodes may also get inflamed or the bacteria can further spread via the blood, causing sepsis.
Diagnosis
The diagnosis of erysipelas is usually easily made by the characteristic symptoms. Optionally, a culture of bacteria can be taken with a cotton swab at places where the skin is damaged.
Treatment
The doctor will prescribe an antibiotics course. It’s important that the patient finishes this course completely, otherwise the erysipelas may come back again. Furthermore, the patient should try to rest the affected part as much as possible. For example, by putting the leg high or putting the arm in a sling. When erysipelas is severe, a patient may be admitted to a hospital for antibiotics to be administered by infusion.
If a person regularly suffers from erysipelas, it’s important to keep the skin clean and to take care and disinfect wounds in time. This way can be prevented to let bacteria get inside. A leg is often bandaged to ensure that the swelling decreases more quickly.
Prognosis
Treatment with antibiotics is almost always followed by a complete cure. But in case of erysipelas of the legs, it regularly happens that the leg remains a little thicker and somewhat red. In some cases, the infection returns at a later moment, especially in those people who had some prior trouble with swollen ankles or legs (lymphedema). Some patients have erysipelas so often, that they must be treated preventively with penicillin injections.
Considerations
- Try to figure out how the bacteria got into the skin. These wounds are often caused by a fungal infection. In order to prevent erysipelas, treat the fungal area with an antifungal cream.
- Wear a bandage or elastic stockings when edema of the legs persist and when the patient has lymphedema.
- Keep, even after the cure of erysipelas of the leg, an eye at the skin between the toes. Dry thoroughly after showering. Fungal infections have a tendency to come back often.
- Overweight increases the chance of recurrence. Moreover, there’s more chance that erysipelas develops more severely. Losing weight can contribute to have fewer risks of erysipelas in the future.
