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Erysipelas on the cheek
Erysipelas on the cheek
Erysipelas on the face
Erysipelas on the face

Erysipelas
Definition:
Erysipelas is a type of cellulitis (skin infection) generally caused group A streptococci.

Causes, incidence, and risk factors:

Erysipelas may affect both children and adults. The risk factors associated with this infection include local trauma (break in the skin), skin ulceration, and impaired venous or lymphatic drainage.

In the past, the face was most commonly involved yet now accounts for only up to 20% of cases. The lower extremities (legs) are affected in up to 80% of cases.
Symptoms:
  • An erysipelas skin lesion typically has a raised border that is sharply demarcated from normal skin. The underlying skin is painful, intensely red, hardened (indurated), swollen, and warm.
  • Facial erysipelas classically involve the cheeks and the bridge of the nose.
  • Blisters may develop over the skin lesion.
  • Fever and shaking chills are common.
Signs and tests:

The diagnosis of erysipelas is based on the characteristic appearance of the skin lesion. Skin biopsies are usually not needed. Blood cultures are rarely positive (up to 5% of the time).
Treatment:
The cornerstone of therapy is treatment with antibiotics such as penicillin, which are active against streptococci. Depending on the severity, intravenous antibiotics may be used. In less severe cases, oral antibiotics may be sufficient. In individuals who have recurrent erysipelas, long-term antibiotics may be required.
Expectations (prognosis):

If appropriate antibiotic therapy is given early, the outcome is favorable. Skin changes may take up to a few weeks to normalize and peeling is common.

In some patients, streptococci may travel to the blood (bacteremia) and additional sites may be involved such as heart valves, joints, and bones.
Complications:
Calling your health care provider:
Call your health care provider if you have a skin lesion that has features of erysipelas.
Prevention:
Avoiding cuts and scrapes may reduce the risk for the development of erysipelas.
Review Date: 7/19/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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