Medical Subjects: Skin

What Is Erysipelas

What disease is erysipelas?

Erysipelas is an acute inflammatory lesion of the lymphatic vessels of the skin and subcutaneous tissue caused by bacterial infection. The more common sites of disease are the lower limbs and head and face, other parts can also occur. Lesion area can appear clearly demarcated edema, red skin, shiny surface tension, and sometimes the skin surface can appear blisters, pustules, skin temperature is high, can have tenderness.

It is common in the elderly and not contagious. The disease can be cured by related treatments, but it still has the risk of recurrence.


What Is The Cause Of Erysipelas

What causes erysipelas?

Erysipelas is mostly caused by group A type B hemolytic streptococcus infection in the skin, mucosa, lymphatic vessels in the subcutaneous tissues and their surrounding tissues.

Why can erysipelas form "elephantiasis legs"?

Hemolytic streptococcus causing erysipelas infection repeatedly invades the lymphatic vessels of the lower limbs, resulting in obstructed lymphatic vessels. Because it is obstructed, the water flowing back through the lymphatic vessels will be detained and will gradually form edema, making the skin thicker and the limbs deformed to form "elephantiasis legs".

Why can erysipelas be caused by tinea pedis?

Tinea pedis is a chronic skin disease with a long course of disease, and the course of disease is long. The skin at the lesion of tinea pedis is likely to be damaged, and the type B hemolytic streptococcus in Group A has a large possibility of invasion from the damaged part. Therefore, patients with tinea pedis should also be treated as soon as possible, if the disease is allowed to persist there is a risk of secondary erysipelas.

Why can erysipelas attack repeatedly?

Repeated episodes of erysipelas may have the following causes:

  • There are local circulatory disorders, such as lymphedema. Erysipelas can lead to damaged lymphatic vessels and even lymphatic obstruction, leading to repeated occurrence of erysipelas.
  • Patients with erysipelas often have some predisposing factors that easily lead to repeated episodes of erysipelas, such as slight damage to the skin, diabetes, and alcohol abuse.
  • Patients with erysipelas may need long-term use of antibiotics or hormones (such as treatment of glomerulonephritis caused by streptococcal infection), which will further cause decreased immunity and bacterial resistance, which are prone to repeated episodes of erysipelas.

Why is the prevalence of erysipelas in the elderly much higher than that in the young and middle-aged?

The overall physical condition of the elderly is worse than that of the young and middle-aged people. They may have medical and surgical history of various diseases, and their ability to resist infection is relatively low. The elderly are also the prone population of "three highs", and they have a relatively high possibility of circulatory system disorders, and dry skin is prone to problems. In summary, the elderly are more likely to suffer from erysipelas than young and middle-aged people.

Why does the risk of erysipelas increase during pregnancy?

During pregnancy, women's immune function is weakened due to hormone changes in the body. At the same time, the fetus will also produce some substances to weaken the maternal immune response. Therefore, the overall immune state of pregnant women is relatively low and they are vulnerable to infection with Group A type B hemolytic streptococcus. In addition, lymphedema occurs easily during pregnancy, resulting in increased risk of erysipelas.

Why does the risk of erysipelas disease increase in diabetic patients?

Elevated blood glucose in patients with diabetes is beneficial to the growth and reproduction of bacteria, so the chance of infection is increased. Diabetes has a variety of complications, such as peripheral neuropathy (unable to feel the slight damage of the skin or even injured due to it), microangiopathy (circulation disorder), skin damage, etc., which leads to the decreased body resistance and is more likely to lead to bacterial invasion. Some invasive examinations and treatments for patients with diabetes may also be easy for bacteria to invade.

Is erysipelas contagious?



What Are The Symptoms Of Erysipelas

What does the skin symptom of erysipelas look like?

What skin symptoms can erysipelas show in addition to systemic symptoms?

Erysipelas starts more quickly and has systemic symptoms such as chills, high fever, headache and nausea, which often occur earlier than skin symptoms.

Why can erysipelas damage renal function?

One of the common pathogens causing erysipelas, group A type B hemolytic streptococcus is also the pathogen causing glomerulonephritis. The group A type B hemolytic streptococcus in erysipelas patients is in an active state, which can affect the kidneys and cause a certain degree of damage to the renal function (mostly mild damage). Therefore, early treatment of erysipelas can reduce the damage to the kidneys.

What critical illnesses can erysipelas cause?

If the treatment of erysipelas is not timely, the infection can be enlarged and intensified. Particularly, a large area of erysipelas can cause pathogens and toxins to invade the blood of the whole body, causing septicemia and even septic shock (low blood pressure caused by toxins). Therefore, early treatment of erysipelas is very important.

What changes does the skin have when erysipelas improves?

When the skin color of the affected part changed from brownish red to dark red, the central swelling of the lesion gradually decreased, and the skin temperature and tenderness tended to be normal, indicating that the patients with erysipelas were in an improved state. Temporary pigmentation and fine desquamation might occur locally after the skin swelling subsided. The duration of the recovery process varied with the disease, and it was generally about 10–30 days.


How To Check For Erysipelas

What diseases can erysipelas be easily misdiagnosed as?

  • Allergic skin diseases: For example, contact dermatitis (there is usually a history of exposure to sensitive irritants but generally no systemic symptoms such as headache, fever and chill).
  • Fungal infectious skin disease: For example, tinea pedis rash (usually occurs when tinea pedis is active; erythema is common; edema is not obvious; systemic symptoms are milder); erysipelas-like tinea pedis rash can also be found.
  • Other: Sweet disease and some immune skin diseases, and the change of illness requires timely return to the outpatient department of the hospital for clarification.

What is the use of blood test routine when erysipelas?

Usually, when the systemic symptoms of erysipelas appear, the routine blood test results in the increase of the total number of white cells, which are mainly neutrophils, and there may be left shift of nuclei and toxic particles. The doctor can confirm the diagnosis of erysipelas based on routine blood test and symptom manifestations, and routine blood test can facilitate the doctor to make the differential diagnosis.


How To Prevent Erysipelas

How can erysipelas be avoided during pregnancy?

  • Pay attention to rest during pregnancy, keep the skin clean, as far as possible to avoid skin injury, such as skin wounds in a timely manner;
  • Pay attention to avoid standing for a long time, pay attention to the appropriate activities of lower limbs when sitting for a long time, to improve the blood circulation of lower limbs.

How does erysipelas prevent reoccurrence?

  • Actively manage risk factors: Repeated episodes of erysipelas should be actively managed by some risk factors that may lead to erysipelas, such as active treatment of lymphedema, obesity, tinea pedis, and some other skin infections。
  • Prophylactic use of antibiotics: The preventive application of antibiotics to patients with repeated relapses may reduce the frequency of recurrence. Patients with chronic relapses can also be improved by physical therapy such as ultraviolet light and He-Ne laser. Patients with severe lymphedema can be treated surgically when necessary.

How Is Erysipelas Treated

What are the local external drugs for erysipelas treatment?

  • Wet compress with magnesium sulfate solution can expand local blood vessels and promote local swelling.Wet compress with magnesium sulfate solution can expand local blood vessels and promote local swelling.
  • The external application of Xiluotuo ointment can prevent the development of inflammation and promote the absorption of hematoma.
  • Topical mupirocin ointment has antibacterial effect.

What are the antibiotics for erysipelas treatment?

As erysipelas is an acute bacterial infectious disease, the concentration of antibiotics in the blood during intravenous drip is higher than that after oral administration of antibiotics; the higher the concentration, the greater the killing effect on bacteria; therefore, infusion is generally adopted.

Penicillin is the first choice for antibiotics to be used for erysipelas treatment; 4.8 million–6.4 million U is given by intravenous drip every day; generally, the body temperature recovers to normal after 2–3 days, but continuous intravenous drip of antibiotics is needed for about 2 weeks to prevent recurrence. Penicillin allergy can choose erythromycin or quinolones.

What are the physical treatments for erysipelas?

Physical therapies for erysipelas include ultraviolet radiation therapy, semiconductor laser radiation therapy, and others.

  • Ultraviolet radiation therapy: UV can accelerate blood circulation in the irradiated area, strengthen metabolism, increase the number of white blood cells, and enhance phagocytosis. As a result, the immunity of patients with erysipelas is enhanced and the infected wound surface is facilitated to be repaired.
  • Semiconductor laser irradiation therapy: Semiconductor laser can accelerate the reproduction process of new cells in blood vessels, promote the release of analgesic substances, and reduce the permeability of blood vessel wall. It has obvious analgesic and edema-reducing effects for patients with erysipelas.

Can erysipelas be cured?

Yes, but there is a risk of recurrence.

The course of erysipelas is an acute process, usually 5–7 days, which can be cured under the premise of timely treatment and proper treatment. Because erysipelas has the possibility of recurrence, close observation is still needed after the symptoms completely resolve.

What key points does erysipelas merge tinea pedis patient's treatment have?

Tinea pedis is a fungal infectious skin disease, and erysipelas is a bacterial infectious skin disease. Therefore, a combination of antifungal drugs and antibiotic drugs is needed for treatment. Antifungal drugs are usually applied to the affected parts together with intravenous antibiotics.

What are the main points of erysipelas combined with diabetes treatment?

Controlling blood sugar is just as important as controlling infection.

  • Daily attention to actively control blood glucose, reasonable use of hypoglycemic drugs and insulin, close monitoring of blood glucose. Pay attention to local cleaning, pay attention to foot care, prevent infection.
  • Seek medical treatment for anti-infection treatment promptly when evidence of infection is found. Infection control is usually achieved by early and adequate intravenous administration of antibiotics. Be aware of possible interactions between sulfonamides and sulfonylureas oral hypoglycemic agents.
  • For patients with poor general conditions, active systemic support treatment is needed to ensure enough heat.

What Should Erysipelas Patients Pay Attention To In Life

What precautions does erysipelas patient's skin care have?

  • Wear loose soft cotton clothes;
  • Pay attention to personal hygiene, keep the skin clean;
  • If the skin feels urticant, should reduce the cause that causes urticant, cannot scratch repeatedly, lest aggravate infection;
  • The affected part is fully exposed to avoid heating, collision and compression.

What should notice on the diet of erysipelas patient?

  • There is no special taboo on diet, and a healthy and balanced diet is enough.
  • Pay attention to less salt when cooking, less oil, less high salt seasoning, eat less pickled vegetables, pickled meat, etc.;
  • Don't only eat refined rice and white flour as the main food; coarse grains, miscellaneous beans, potatoes, and pumpkins can be used to replace some of the main food.
  • Reasonable collocation of meat and vegetable, meat preferred chicken, duck, fish and other white meat, eat less fat, eggs, milk is an important source of protein and other nutrients;
  • If you are a vegetarian, you can eat more beans and soy products to supplement protein;
  • Eat more fruits and vegetables;
  • Try not to drink.

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