Erysipelas is a skin disease caused by bacteria (A-streptococci or ß-hemolytic streptococci). It results in typical inflammation of the skin and highly visible reddening of the skin. Erysipelas occurs mostly on the leg or face and is not infrequently accompanied by severe fever.
What is erysipelas?
Typical features of erysipelas are redness of the skin. The deep red areas have a sharp border with healthy areas of skin in the immediate vicinity. Erysipelas, known in medical terminology as erysipelas and popularly as erysipelas, describes a reddening of the skin. This is sharply defined and clearly visible, taking the form of a flame on the skin. Erysipelas occurs when bacteria settle in minimal wounds and the area becomes inflamed – the uppermost layers of the skin and the lymphatic channels are usually affected. Erysipelas is particularly common on the leg, arms or face, where it can occur anywhere. More rarely, the redness or erysipelas is also encountered in the area of the belly button.
Causes
The causative agent of erysipelas is bacteria. In most cases, these are ß-hemolytic streptococci. These dissolve red blood cells in humans. Occasionally, other bacteria are responsible for erysipelas, such as staphylococci or rods. The bacteria enter through small wounds that occur in the top layer of the skin. These can be caused by athlete’s foot or neurodermatitis, for example, which makes them hardly noticeable. Often, when erysipelas breaks out, the wound responsible can no longer be found because it is so small and heals quickly. Other entry portals for the pathogens of erysipelas are larger wounds, such as fissures (rhagades), which provide access to the uppermost layer of skin. Once the pathogens have found an entry portal, they can settle around the wound and begin to multiply. This is how erysipelas eventually develops.
Symptoms, complaints, and signs
In most cases, the first signs of erysipelas develop on the legs or lower legs. Less commonly, symptoms occur on the arms or face (facial erysipelas). Typical features of erysipelas are reddish areas of inflammation on the skin. The deep red areas have a sharp border to healthy skin areas in the direct vicinity. The shape and course do not follow a clear pattern and appear very irregular. In advanced and deep-seated erysipelas, the inflammation loses its characteristic contour and runs more smoothly into the surrounding skin. In addition to pronounced swelling, those affected also suffer from increased sensitivity to pressure in the diseased area. By placing the hand on the skin, a clear increase in temperature due to infectious processes becomes noticeable. Lymph nodes in the immediate vicinity react to erysipelas by painful enlargement. Typical symptoms such as fever over 39° Celsius, chills, joint pain or a great lassitude accompany the symptoms in varying intensity. Patients complain of impairments that in many cases are reminiscent of an incipient flu. In the case of recurrent erysipelas, general complaints such as a feeling of weakness and fatigue recede into the background. In turn, the relapse leads to the development of lymphedema due to damaged lymphatics. Severe cases provoke a rampant infection with dying tissue. In addition to circulatory shock due to blood poisoning, cardiomyopathy and the development of meningitis are also within the realm of possibility.
Disease progression
Initially, the bacterial pathogens of erysipelas enter the body through the wound. The incubation period is about 2 to 5 days. Within this time, the wound may have already healed – it depends on its size. The first symptoms of erysipelas appear suddenly. The affected person first suffers from fever, accompanied by severe chills. Erysipelas itself becomes visible only a few hours after the onset of the first symptoms. The skin reddens at this stage, and the redness spreads rapidly. It is characterized by its bright red color and is usually flame-shaped. The expression of erysipelas can be so mild that only a few red dots are visible on the skin – but it can also become much more pronounced. The inflamed area gradually swells clearly visible.In some severe cases, blisters form that can bleed into the skin. These are called bullous erysipelas.
Complications
If erysipelas is treated too late or not adequately, several complications can occur, especially in people with immune deficiencies or other medical conditions. The inflammation can clog the lymphatic channels, preventing lymph fluid from draining properly and causing it to back up in the tissues (lymphedema). Because the affected tissue is not optimally supplied with nutrients as a result, there is thus a risk that individual streptococci will survive, multiply and cause erysipelas again. In severe cases or if treatment is inadequate, severe swelling may occur, leading to elephantiasis with severely swollen legs. Furthermore, inflammation of the surrounding veins may occur. In rare cases, life-threatening sepsis may occur if bacteria enter the bloodstream. Erysipelas can also lead to complications in the kidneys if antibodies are formed in the body because they are mistaken for streptococci due to similarities. Very dangerous, although rare, is facial erysipelas, in which bacteria can enter the brain and cause meningitis or cerebral venous thrombosis. Erysipelas has the disadvantage that it can recur and also become chronic.
When should you go to the doctor?
Changes in the appearance of the skin are basically a sign that there are discrepancies in the organism. If the abnormalities persist for several days or weeks or have an increasing character, a doctor should be consulted. Worrying are reddening of the skin, itching or pain. To avoid complications or secondary diseases, a doctor should be consulted at the first signs. If the affected person suffers from inflammation of the skin, clarification of the cause is advisable immediately. In case of fever, fatigue, internal weakness, exhaustion as well as a decrease in physical strength, medical care is required. If the general performance of the affected person is reduced, he should seek help. Swelling of the lymph as well as flu-like symptoms should also be presented to a physician. If there are rapid and progressive changes in general health, acute action is required. If well-being deteriorates rapidly within a short period of time, hospitalization should be sought. If left untreated and if the course of the disease is unfavorable, the affected person may develop a life-threatening condition. He may suffer from blood poisoning due to the symptoms, which can take a fatal course. If edema develops or if the affected person suffers from emotional stress due to the altered skin appearance, a visit to the doctor is necessary. Complaints of the joints, restrictions of mobility as well as chills should also be examined.
Treatment and therapy
Patients are treated differently depending on the severity of erysipelas. For some, medication is administered under the supervision of the general practitioner, while others require hospitalization. As soon as erysipelas turns into bullous erysipelas, the patient is admitted to the hospital. There he receives strong antibiotics in particularly high doses to kill the pathogens of erysipelas. Penicillin or cephalosporins are often administered intravenously. When blistering erysipelas heals, scars may remain on the skin, and patients who have had heart valve surgery are at risk. In milder forms of erysipelas without impairment, it is sufficient to prescribe antibiotics in tablet form. In any case, however, the cause of erysipelas must be treated to prevent recurrent infection.
Aftercare
Erysipelas is a serious infection that should definitely be treated by a doctor. The patient must follow the doctor’s orders and take the prescribed medication – usually antibiotics – regularly. Sufficient rest and sparing are important for the healing process. Stress should be avoided as far as possible, and patients should avoid stimulants such as cigarettes and alcohol as much as possible. A healthy diet with plenty of fresh fruit and vegetables provides the necessary vitamins and minerals to restore the patient’s strength. When the patient feels better, moderate exercise can be started.It is helpful to take long walks outdoors, which have a positive effect on the condition and stimulate the immune system. The immune system should definitely be strengthened in order to be able to successfully fight off the infection. Erysipelas may be associated with blistering in its course. To avoid the formation of unsightly scars, especially in the case of facial erysipelas, the affected skin areas should be carefully cared for during the further course of healing. The attending physician can recommend appropriate care products. The patient can then carefully apply and massage in the creams or ointments themselves to keep the tissue supple and thus prevent scarring.
Home remedies and herbs for redness of the skin
- Make an infusion with 100 grams of fennel herbs. With this addition to the bath, skin redness is relieved and a relaxing effect is achieved.
What you can do yourself
In most cases, the patient is already under medical treatment when it becomes known that the skin condition is erysipelas. It is then important that the patient understands that this is a serious infection and that the doctor’s instructions must be followed urgently. During the time the patient is taking appropriate medication – usually antibiotics – he or she should take it easy and make sure to get enough rest and sleep. In addition, the patient should avoid stress and abstain from stimulants such as alcohol and cigarettes. A healthy diet supports recovery. Fresh fruit and vegetables provide many vitamins and minerals. Light, lean meat and whole grain products are also recommended. On the one hand, the diet should restore the patient’s strength, but on the other hand it should not be a burden. Fast food is not suitable for this. As soon as the patient feels reasonably fit, exercise is recommended, preferably outdoors. Long walks restore fitness and stimulate the immune system, which should support the healing process. If erysipelas was accompanied by blistering, it can be carefully cared for during the healing process to prevent scarring. Appropriate scar creams or ointments will be recommended by the dermatologist. They should be massaged in regularly, but with extreme care, so that on the one hand the wound is not excessively tugged and rubbed, but on the other hand the tissue is kept supple.
