Erysipelas, also known as erysipelas or erysipelas, is a skin infection that usually occurs on the leg or face. Symptoms include redness of the affected area and a general feeling of illness. The cause of erysipelas is a bacterial infection, often as a result of a small skin injury, such as athlete’s foot or an insect bite. Without early treatment with antibiotics, the infection can have serious consequences.
Typical symptoms of erysipelas
The typical symptoms of erysipelas include a severe, shiny as well as flame-shaped redness of the skin that is clearly limited and not purulent. The inflammation spreads over a large area around the entry point of the pathogen within a short time. Although erysipelas can occur all over the body, erysipelas often develops on the leg (especially the foot and lower leg), face, arm or navel. The following accompanying symptoms of erysipelas are possible:
- General feeling of illness and fatigue
- Burning, itching, tightness or heating of the skin
- Painful, pressure-sensitive swelling of the affected area.
- Joint pain and headache
- Fever
- Shivering to chills
- Nausea
- Swelling of the nearby lymph nodes
- Blisters or pustules, small hemorrhages
The above symptoms can, but do not have to be accompanied by erysipelas. Also an inconspicuous course without clearly visible redness and accompanying symptoms is possible. Especially with the repeated occurrence of erysipelas, the cold-like symptoms often remain absent.
Erysipelas: how is the diagnosis made?
In the case of erysipelas, a physician can often already make the diagnosis based on the visible symptoms and physical complaints of the affected person. Part of the diagnosis is always the search for the entry point of the pathogen, for example, a wound or fungal infection. In addition, there is a questioning or examination with regard to any risk factors, i.e. concomitant or previous illnesses that favor erysipelas. In addition, a blood test or (less frequently) a smear test can supplement the diagnosis and help to determine the extent of the inflammation or the pathogen.
Differentiation from other diseases
A central component of the diagnosis of erysipelas is differentiation from other diseases. These include:
- Shingles (herpes zoster)
- Phlegmon (a purulent inflammation, often resulting from a wound or ulcer).
- Non-infectious inflammation in chronic venous insufficiency (on the lower leg).
- Phlebitis or venous thrombosis in the leg
- Redness at the wound edge as part of the wound healing process
- Lyme disease
- Allergic reaction
In addition, in the linguistic sense, it is also necessary to pay attention to a demarcation: Thus, erysipelas on the face is called “facial rose”. However, this term can also mean shingles on the face.
Erysipelas: course and consequences
In the course of erysipelas, the pathogens spread along the lymphatic fissure and lymphatic vessels, where they cause inflammation that the body uses to try to fight the bacteria. If erysipelas is not treated early enough or not sufficiently, there is sometimes a risk of serious consequences. The pathogens spread quickly throughout the body and can trigger various complications:
- Hemorrhages and blisters in the upper layers of the skin.
- Clogging of the lymphatic channels (lymphatic swelling or lymphedema up to elephantiasis nostras)
- Venous inflammation and acute thrombosis
- Spread to deeper layers of the skin (phlegmon).
- Blood poisoning
- Inflammation of the kidney or inner wall of the heart (endocarditis)
- Meningitis or cerebral venous thrombosis as a rare consequence of facial erysipelas.
If erysipelas occurs again in the same place after it has subsided, this is called a relapse or recurrence. The risk of this is particularly high if there are additional risk factors, such as diabetes or venous disease.
Early therapy with antibiotic
Early treatment usually allows erysipelas to heal after a few days. As part of the therapy is also the thorough cleaning and care of the entry point of the germ is important to avoid relapses. Treatment of erysipelas is usually by antibiotic, usually penicillin.The drug is administered intravenously or as a tablet, depending on the severity of the infection. This may sometimes require inpatient treatment in a hospital. Antibiosis, i.e. treatment with antibiotics, is usually administered over a period of 10 to 14 days. In chronic erysipelas, long-term administration of antibiotics helps.
Other measures in erysipelas
In addition to the administration of antibiotics, the following measures are available for the treatment of erysipelas:
- Anti-inflammatory and antipyretic analgesics.
- Injections for the prevention of thrombosis
- Lymphatic drainage if lymphatic congestion persists after the erysipelas has healed
- A compression bandage or support stockings prevent after the swelling of the affected area that fluid is deposited in the tissue again
Tips for the treatment of erysipelas
Anyone suffering from erysipelas should move the affected area as little as possible, so that the infection does not spread. Bed rest may therefore be advisable, but it also increases the risk of thrombosis. Sufferers should also follow these tips:
- Avoid talking and chewing movements in facial erysipelas, for example, using strained foods.
- If arms or legs are affected, you should store them elevated to improve lymphatic drainage.
- Cool the affected area. But be careful: too much cooling could hinder blood flow to the vessels.
- With skin creams you can prevent your skin from becoming dry and cracked.
Although many people prefer homeopathy, erysipelas is a serious disease that always requires a visit to the doctor and must be treated with antibiotics. Homeopathic ointments can be used at most supportive to combat swelling.
Streptococcus as a cause
Erysipelas is an acute bacterial skin disease that is usually caused by streptococci (less commonly by staphylococci). The bacteria often already live on the skin and enter the body through small skin lesions to multiply in the deeper layers of the skin. As a result, swelling and redness of the skin occur in the affected areas. Such ports of entry in the skin often occur as a result of athlete’s foot, insect bites, scratches, cracked skin, eczema or fungal infections.
Risk factors for erysipelas
People with weakened immune systems, for example as a result of surgery, as well as children and the elderly, are particularly susceptible to the disease. Certain diseases also increase the risk of contracting erysipelas. For example:
- Lymphedema
- Diabetes mellitus
- Leg swelling and venous disease
- Circulatory disorders
Erysipelas is not contagious in the usual sense: although the pathogens can be transmitted from person to person. However, an uninjured skin and a healthy immune system can usually fight off the bacteria. Therefore, there is usually no risk of infection.
Prevent erysipelas
Erysipelas cannot be completely prevented, but it can be prevented by minimizing risk factors. If you suffer from a disease that is conducive to erysipelas, have it well treated. Examine yourself regularly for injuries, especially on the legs. Professional foot care is recommended, especially if you have diabetes, so that your feet are examined and cared for by professionals. Seek medical attention immediately if erysipelas is suspected. If injuries to the skin occur, clean and disinfect them carefully to prevent erysipelas.
