What is it about ?
Erysipelas is a skin infection caused by a bacteria called streptococcus. This bacteria is present in everyone. It is harmless on intact skin. Usually, it enters the skin through a small wound, which we then call the contamination gateway. From there, it spreads to the skin and to the subcutaneous tissues. The entryway could be a simple scratch or a pre-existing lesion such as a leg ulcer or a fungal infection (yeast infection) between the toes. If you have diabetes, poor blood circulation, or a condition that causes decreased resistance, you are at a higher risk of developing erysipelas.
What is its frequency?
About 5 in 1,000 people develop erysipelas each year, women are affected as much as men.
How to recognize it?
Erysipelas most often occurs on the legs. A red, hot and quickly growing patch appears on the skin. The contour of the plate is slightly raised; you can feel it when you touch it with your finger. After a few days, blisters may be visible; they can tear spontaneously. Nearby lymph nodes (for example, lymph nodes in the groin in the case of erysipelas on the leg) may swell and become painful. Sometimes a red streak appears from the lesion to these nodes (lymphangitis). Very quickly you will have general symptoms such as fever, muscle aches, headaches, and nausea.
Usually you will find a small sore in the area that served as the front door. But it happens that you find this sore at a certain distance from the erysipelas.
How is the diagnosis made?
The appearance of an erysipelas is usually quite characteristic. Your doctor can usually diagnose it on sight. In severe cases, a blood test is done. In erysipelas, the number of white blood cells is high and inflammatory proteins are present.
If erysipelas is suspected, the doctor will start treatment immediately, even before knowing the blood result.
What can you do ?
The main preventive measure against erysipelas is to properly clean and disinfect wounds. It is best to have a venous ulcer treated by nurses at home. An elastic bandage prevents the accumulation of fluid in the leg and promotes the healing process.
Do not wait to react if you have yeast infection between your toes. Many people who wear special work shoes have them. Wash your feet twice a day, wipe them well until they are completely dry. If necessary, use a hair dryer. Then apply a cream that kills fungi (anti-fungal cream, fungicide).
If you see a red plaque, mark it with a marker. This way you will be able to see if its size is increasing. If so, see your GP as soon as possible. Early treatment will likely prevent hospitalization.
What can your doctor do?
The doctor will start by giving you high-dose antibiotics right away. He will prefer a penicillin, flucloxacillin. If you are allergic to penicillins, azithromycin or clindamycin is a good alternative. Your doctor will also prescribe pain relievers, such as paracetamol.
It is recommended that you do not walk too much or stand for too long. Try to lift your leg as much as possible to avoid swelling. When erysipelas heals, the skin often peels (peeling).
Hospitalization is necessary if, despite this treatment, no improvement is observed. In the hospital, antibiotics are given as an infusion.
If erysipelas comes back frequently (for example 3 times in a few years), you may be prescribed antibiotics regularly to prevent another episode.
The doctor will obviously look for the entry point of the contamination, and he will treat the wounds and the yeast infections. In case of chronic infections and venous ulcer, a blood test is done to check for possible diabetes. An examination of the blood vessels will also be done.
Want to know more?
- Erysipelas: consequence of an untreated wound – mongeneraliste.be – SSMG – Société Scientifique de Médecine Générale
- Bullous erysipelas (image) – DermIS – Dermatology Information System
- Flucloxacillin – CBIP – Belgian Center for Pharmacotherapeutic Information
- Azithromycin – CBIP – Belgian Center for Pharmacotherapeutic Information
- Clindamycin – CBIP – Belgian Center for Pharmacotherapeutic Information
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
Source