Medical history (history of illness) represents an important component in the diagnosis of erysipelas (erysipelas). Family history What is the general health of your relatives? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). Have you noticed any changes in the skin? Where is the skin change localized? What does the skin change … Erysipelas: Medical History
Skin and subcutaneous (L00-L99). Acute contact dermatitis (contact dermatitis; skin lesions caused by skin contact with certain substances). Cardiovascular system (I00-I99). Chronic venous insufficiency (CVI) with stasis dermatitis and hypodermitis (inflammation of the subcutis). Phlebitis (inflammation of the veins) Deep vein thrombosis (TBVT) Infectious and parasitic diseases (A00-B99). Erysipeloid (porcine erysipelas). Erythema chronicum migrans (first … Erysipelas: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by erysipelas (erysipelas): Skin and subcutaneous (L00-L99). Lymphangitis (inflammation of the lymphatic vessels). Cardiovascular system (I00-I99) Elephantiasis – abnormal enlargement of a body part due to lymphatic congestion. Lymphedema – increase in tissue fluid caused by damage to the lymphatic system. … Erysipelas: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing) of skin [due topossible symptoms: Sharply limited strongly pronounced erythema (areal redness of the skin). Flame-shaped extensions Blistering possible (bullous erysipelas); scarring may occur after the … Erysipelas: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count [leukocytosis/increase in white blood cell count] Differential blood count Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin) [↑] Blood cultures – if there is evidence of a systemic inflammatory response. Laboratory parameters 2nd order – depending on the results of the … Erysipelas: Test and Diagnosis
Therapeutic targets Elimination of the pathogens Pain relief Therapy recommendations Immediate antibiosis (antibiotic therapy: penicillin, first-line agent); duration of therapy: oral for ten days (-14 days); even milder cases should be treated for at least 7 daysOther antibiotics depending on: e.g., penicillin allergy, V. a. S. aureus(-participation), V. a. Gram-negative pathogens (-participation) Antiseptic therapy (germ-reducing … Erysipelas: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Duplex sonography (ultrasound examination: combination of a sonographic cross-sectional image (B-scan) and the Doppler sonography method; medical imaging method that can dynamically visualize fluid flows (especially blood flow)) for … Erysipelas: Diagnostic Tests
The following symptoms and complaints may indicate erysipelas (erysipelas): Leading symptoms Sharply demarcated bright redness of the skin above the level of the skin Flame-shaped extensions Confined to the epidermis (upper skin) and dermis (dermis) (no or superficial involvement of the subcutis (lower skin)) Blistering possible (bullous erysipelas); if there is bleeding is called hemorrhagic … Erysipelas: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Erysipelas is a nonpurulent skin infection caused by β-hemolytic streptococci of group A (Streptococcus pyogenes), more rarely of group C or G, and only in exceptional cases – especially in newborns – of group B. It originates from a skin defect such as a wound or also a mycosis (fungal skin … Erysipelas: Causes
General measures Bed rest Elevate, immobilize and cool affected extremity In facial serysipelas prohibition of speech and soft food. Hospitalization: Severe courses (blistering (erysipelas vesiculosum et bullosum) and bullous-hemorrhagic (blistering-bleeding) erysipelas, phlegmonous (“spreading diffusely”) or necrotizing (“associated with local tissue death (necrosis)”). Localization in the face (cave cerebral venous thrombosis!) → Anticoagulation (inhibition of blood … Erysipelas: Therapy
