Brief overview
- Causes and risk factors: Bacterial infection of the skin primarily with streptococci, entry sites are usually injuries, skin wounds, insect bites, increased risk with diabetes mellitus, immunodeficiency, skin diseases, and other conditions
- Symptoms: Extensive, usually sharply defined redness and swelling of the skin, possibly swelling of the lymph nodes, fever, general feeling of illness.
- Treatment: Antibiotics
- Examinations and diagnosis: Usually on the basis of the typical course, if necessary exclusion of other similar-looking diseases.
- Prevention: Medical foot care for certain risk groups (e.g. diabetics), careful treatment and care of skin diseases
What is erysipelas (erysipelas)?
Because the inflammation spreads around the entry site of the pathogen, the appearance is reminiscent of a rose petal, hence the name erysipelas.
In general, it is possible for erysipelas to form on all sorts of skin sites. Often erysipelas forms on the leg, sometimes on the face.
Is erysipelas contagious?
Even if some people think so – erysipelas is not contagious. So it does not pass from one person to another.
Many other diseases caused by the same bacteria (mainly Streptococcus pyogenes), on the other hand, are very contagious – for example scarlet fever and the skin disease impetigo contagiosa. However, in these cases, the routes of infection and the spread of the pathogen are different.
Erysipelas is an inflammation of various layers of the skin caused by bacteria, which spreads to all sides, giving rise to the reddish inflammatory halo. Most often, erysipelas is caused by a particular type of streptococcus: Streptococcus pyogenes.
However, other streptococci and, in some cases, staphylococci (another genus of bacteria) also sometimes cause erysipelas. However, these pathogens are much rarer as causes.
Streptococci occur naturally on the skin and mucous membranes of most people without causing any symptoms. Other bacteria also settle on our skin without making us sick. Intact skin is a natural barrier that protects us from potential pathogens.
However, if a skin injury occurs, these bacteria penetrate the skin and cause inflammation.
The natural “carpet” of microorganisms on the intact skin (skin flora) is not only harmless, but even useful – it contributes to protection against infection with harmful pathogens.
Favouring factors for erysipelas
- Heart failure
- Kidney damage
- Varicose veins
- Impaired lymphatic drainage, e.g. after breast cancer surgery (lymphedema as a possible consequence)
- Malnutrition
- Circulatory disorders
Skin diseases and injuries that impair the protective function of the skin are also risk factors for erysipelas:
- Skin fungus
- @ Dry, cracked skin
- @ Neurodermatitis
- Minor injuries to the skin or nail bed
- After an insect bite or from animal bites
Normally, erysipelas does not have a psychological cause. However, severe mental stress sometimes contributes to a weakening of the body’s defenses.
An intact blood supply also ensures rapid wound healing and thus closure of the entry site. This means that diseases and therapies that impair the immune system and/or blood supply potentially favor erysipelas. These include, for example:
- Diabetes mellitus
- @ Chemotherapy for cancer
- Arteriosclerosis
- HIV/AIDS
Especially children and elderly people are more often affected by glanders. On the one hand, because of their less efficient immune system, and on the other hand, because they injure themselves more quickly.
What are the symptoms of erysipelas (erysipelas)?
In severe cases of erysipelas, blisters form (bullous erysipelas). In addition, the neighboring lymph nodes swell and are sensitive to pressure.
Often it is not the skin changes that prompt sufferers to visit a doctor, but the non-specific accompanying symptoms of erysipelas:
Even though erysipelas occurs on almost all parts of the skin, it is more common on the leg, lower legs, foot or face.
How long does erysipelas last?
It is not possible to say in general how long erysipelas lasts or how long a person is on sick leave due to erysipelas. The course depends, among other things, on how early treatment is given and whether it is effective.
If erysipelas is recognized early and treated correctly, the prognosis is generally good.
They are therefore often recommended regular medical foot care. This can reduce the risk of (repeated) erysipelas.
Possible complications
Serious consequences are possible if erysipelas is inadequately or unsuccessfully treated:
There is a risk that this swelling will promote renewed erysipelas. Efficient therapy breaks this vicious circle.
If left untreated, erysipelas sometimes spreads to deeper layers of the skin (phlegmon), causing considerable tissue damage.
If left untreated, erysipelas on the face sometimes results in meningitis or blood clots in a cerebral vessel (cerebral venous thrombosis).
All of these potentially life-threatening complications can be prevented if erysipelas is treated early and consistently.
How can erysipelas be treated?
You can read about how erysipelas is treated in the article Erysipelas – Therapy.
How does the doctor diagnose erysipelas?
A bacterial culture from blood usually yields results only when bacteria have entered the bloodstream in large numbers.
It is important to find the entry point of the bacteria. In the case of erysipelas on the face, for example, pimples or small tears in the corners of the mouth (rhagades) have often allowed the germs to enter the tissue. In addition, the physician clarifies which risk factors may have favored the erysipelas.
Exclusion of other causes
Possible differential diagnoses of erysipelas include:
- phlebitis (thrombophlebitis)
- Stasis dermatitis (skin inflammation as a result of venous stasis, usually in chronic venous insufficiency)
- Lyme disease after a tick bite
- Contact eczema (contact dermatitis)
- Herpes zoster in the initial stage
- Erysipeloid (“swine erysipelas”): Similar to erysipelas, but usually milder and caused by a different bacterium
- Inflammatory breast carcinoma (inflammatory form of breast cancer)
For people with risk factors for erysipelas, there are certain preventive measures.
For example, it is advisable for diabetics, and if necessary also for older people, to regularly visit a medical foot care center. This allows pressure points or unnoticed skin lesions to be detected and treated at an early stage.
It is also advisable for people with certain skin diseases, such as neurodermatitis, to contact a doctor promptly if the skin condition worsens.
