Erysipelas

The erysipelas or érésipèle of the Greek érusipelas , is an acute dermo-hypodermite not necrosing (Infection Derme and hypoderme) occurring around a skin trouble evil or not neat (Plaie, Impétigo, mycosic lesion of the folds (intertrigo), etc) or of a natural opening (eye, nose, etc).

It reaches especially the adults after 60 years. More than 85% of erysipelases occur with the lower extremities.

Diagnosis

Clinical diagnosis

The skin is red, luisante and painful: it is the inflammatory wall cupboard cutaneous. A edema very frequently appears. The general signs are marked, with a high Fièvre (absent in 30% of the cases), occurring in a very brutal way, and being able to be complicated by disorders of the conscience.

On the level of the face, there exists a peripheral pad delimiting erysipelas, whereas it is absent when erysipelas reached the lower extremities.

A satellite Adenopathy or a Lymphangite is sometimes present. The search for an infectious main door is essential, but it is not always found (case of a simple primary lesion by scraping for example).

Differential diagnosis

  • fasciite necrosing whose signs of gravity are the cutaneous hypoesthesy, the aspect cyanosite of the skin, the hemorrhagic bulleuses formations, odor.
  • major venous Thrombosis
  • dermatite of acute damning up
  • eczema

Supporting factors

Antecedents of erysipelas, wounds, ulcerations cutaneous, post-operative traumatisms, intertrigo of the toes, psoriasis, eczema, chronic edema, overweight, diabetes, arteriopathy of the lower extremities.

Bacteriology

Streptocoque S are retouvés in 80% of the cases, in particular of type has and G. In 15% of the cases it acts of gilded staphilococca. Seldom one finds negative bacilli gram
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