Erysipelas

It is an acute bacterial infection that affects the outermost layers of the skin and superficial lymphatic vessels, forming sharp red plaques with highly distinct borders.

It is mostly caused by 'Group A beta-hemolytic streptococcus' bacteria. These bacteria enter under the skin through small openings in the skin, such as a scrape, an insect bite, a fungal infection (especially athlete's foot), or a surgical wound, and initiate the disease.

The disease usually begins with a sudden high fever, chills, and general weakness. Then, most commonly on the legs or face; bright red, raised from the skin, very painful to the touch, hot swellings (plaques) with very clearly drawn edges like a map appear.

Cellulitis is the inflammation of much deeper layers of the skin, and the edges of the redness are indistinct (they fade away). Erysipelas is more superficial, and the borders of the redness are very sharp and distinct, as if drawn with a pencil.

The clinical examination (characteristic appearance of the lesion) by an Infectious Diseases or Dermatology specialist is usually sufficient for diagnosis. Sometimes, blood tests (CRP, Leukocytes) are requested to see the severity of the infection.

Because the disease is bacterial, the basis of the treatment is Penicillin or equivalent Antibiotics. With antibiotics given in the form of pills or injections, the disease is usually completely cured within 1 week without leaving a trace. Resting the leg elevated above heart level is a great help in reducing edema.