Erysipelas physical examination: Difference between revisions

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Latest revision as of 21:39, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S., Kiran Singh, M.D. [2]

Overview

Erysipelas manifests with a characteristic rash, localized on the epidermis. Signs include erythema, edema, bullae, vesicles, and blebs. It usually manifests on the legs, but can also be found on the face, torso, hands, feet, and toes. The patient may also be ill-appearing if there is presence of systemic illness, such as fever, chills, or vomiting.

Physical Examination

Appearance of the Patient

The patient may be ill-appearing if systemic illness such as fever, chills, or vomiting is present.^[1]

Vital signs

Fever may be present in erysipelas patients.

Skin

Erysipelas manifests with a characteristic rash, localized on the epidermis, with the following presentation:^[2]

Erythema
Edema
Sharp, demarcated edges between inflamed and normal tissue
Bullae
Vesicles^[3]
Blebs^[4]

Extremities

Erysipelas is most commonly found in the leg.^[5]

Secondarily, it is found on the face, as well as torso, toes, feet, and hands.^[6]

Examples of Physical Examination Findings for Erysipelas

References

↑ {{cite journal |vauthors=Inghammar M, Rasmussen M, Linder A |title=Recurrent erysipelas--risk factors and clinical presentation |journal=BMC Infect. Dis. |volume=14 |issue= |pages=270 |year=2014 |pmid=24884840 |pmc=4033615 |doi=10.1186
↑ Bläckberg A, Trell K, Rasmussen M (2015). "Erysipelas, a large retrospective study of aetiology and clinical presentation". BMC Infect. Dis. 15: 402. doi:10.1186/s12879-015-1134-2. PMC 4590694. PMID 26424182.
↑ Chong FY, Thirumoorthy T (2008). "Blistering erysipelas: not a rare entity". Singapore Med J. 49 (10): 809–13. PMID 18946616.
↑ Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE. PMID 26866211. Missing or empty |title= (help)
↑ Bernard P, Chosidow O, Vaillant L (2002). "Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial". BMJ. 325 (7369): 864. PMC 129632. PMID 12386036.
↑ Krasagakis K, Samonis G, Maniatakis P, Georgala S, Tosca A (2006). "Bullous erysipelas: clinical presentation, staphylococcal involvement and methicillin resistance". Dermatology (Basel). 212 (1): 31–5. doi:10.1159/000089019. PMID 16319471.
↑ ^7.00 ^7.01 ^7.02 ^7.03 ^7.04 ^7.05 ^7.06 ^7.07 ^7.08 ^7.09 ^7.10 ^7.11 ^7.12 ^7.13 ^7.14 ^7.15 ^7.16 ^7.17 ^7.18 ^7.19 ^7.20 ^7.21 ^7.22 ^7.23 ^7.24 ^7.25 ^7.26 ^7.27 ^7.28 ^7.29 ^7.30 ^7.31 ^7.32 ^7.33 ^7.34 ^7.35 ^7.36 "Dermatology Atlas".

Template:WH Template:WS

[pmid24884840-1] {{cite journal |vauthors=Inghammar M, Rasmussen M, Linder A |title=Recurrent erysipelas--risk factors and clinical presentation |journal=BMC Infect. Dis. |volume=14 |issue= |pages=270 |year=2014 |pmid=24884840 |pmc=4033615 |doi=10.1186

[pmid26424182-2] Bläckberg A, Trell K, Rasmussen M (2015). "Erysipelas, a large retrospective study of aetiology and clinical presentation". BMC Infect. Dis. 15: 402. doi:10.1186/s12879-015-1134-2. PMC 4590694. PMID 26424182.

[pmid18946616-3] Chong FY, Thirumoorthy T (2008). "Blistering erysipelas: not a rare entity". Singapore Med J. 49 (10): 809–13. PMID 18946616.

[pmid26866211-4] Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE. PMID 26866211. Missing or empty |title= (help)

[pmid12386036-5] Bernard P, Chosidow O, Vaillant L (2002). "Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial". BMJ. 325 (7369): 864. PMC 129632. PMID 12386036.

[pmid16319471-6] Krasagakis K, Samonis G, Maniatakis P, Georgala S, Tosca A (2006). "Bullous erysipelas: clinical presentation, staphylococcal involvement and methicillin resistance". Dermatology (Basel). 212 (1): 31–5. doi:10.1159/000089019. PMID 16319471.

[Dermatology_Atlas-7] 7.00 ^7.01 ^7.02 ^7.03 ^7.04 ^7.05 ^7.06 ^7.07 ^7.08 ^7.09 ^7.10 ^7.11 ^7.12 ^7.13 ^7.14 ^7.15 ^7.16 ^7.17 ^7.18 ^7.19 ^7.20 ^7.21 ^7.22 ^7.23 ^7.24 ^7.25 ^7.26 ^7.27 ^7.28 ^7.29 ^7.30 ^7.31 ^7.32 ^7.33 ^7.34 ^7.35 ^7.36 "Dermatology Atlas".

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Erysipelas}}
-Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
+{{CMG}}; {{AE}} {{LRO}}, {{KS}}
-{{CMG}}
 ==Overview==
-The erythematous skin lesion enlarges rapidly and has a sharply demarcated raised edge. It appears as a red, swollen, warm, hardened and painful [[rash]], similar in consistency to an orange peel. More severe infections can result in [[vesicles]], [[blister|bullae]], and [[petechiae]], with possible skin [[necrosis]]. [[Lymph node]]s may be swollen, and [[lymphedema]] may occur. Occasionally, a red streak extending to the lymph node can be seen.
+Erysipelas manifests with a characteristic [[rash]], localized on the [[epidermis]]. Signs include [[erythema]], [[edema]], [[Bullous|bullae]], [[vesicles]], and [[bleb|blebs]]. It usually manifests on the legs, but can also be found on the face, torso, hands, feet, and toes. The patient may also be ill-appearing if there is presence of systemic illness, such as [[fever]], [[chills]], or [[vomiting]].
+==Physical Examination==
+===Appearance of the Patient===
+The patient may be ill-appearing if systemic illness such as [[fever]], [[chills]], or [[vomiting]] is present.<ref name="pmid24884840">{{cite journal |vauthors=Inghammar M, Rasmussen M, Linder A |title=Recurrent erysipelas--risk factors and clinical presentation |journal=BMC Infect. Dis. |volume=14 |issue= |pages=270 |year=2014 |pmid=24884840 |pmc=4033615 |doi=10.1186</ref>
+===Vital signs===
+[[Fever]] may be present in erysipelas patients.
+===Skin===
+Erysipelas manifests with a characteristic [[rash]], localized on the [[epidermis]], with the following presentation:<ref name="pmid26424182">{{cite journal |vauthors=Bläckberg A, Trell K, Rasmussen M |title=Erysipelas, a large retrospective study of aetiology and clinical presentation |journal=BMC Infect. Dis. |volume=15 |issue= |pages=402 |year=2015 |pmid=26424182 |pmc=4590694 |doi=10.1186/s12879-015-1134-2 |url=}}</ref>
+*[[Erythema]]
+*[[Edema]]
+*Sharp, demarcated edges between [[inflamed]] and normal [[tissue]]
+*[[Bullous|Bullae]]
+*[[Vesicles]]<ref name="pmid18946616">{{cite journal |vauthors=Chong FY, Thirumoorthy T |title=Blistering erysipelas: not a rare entity |journal=Singapore Med J |volume=49 |issue=10 |pages=809–13 |year=2008 |pmid=18946616 |doi= |url=}}</ref>
+*[[Bleb|Blebs]]<ref name="pmid26866211">{{cite journal |vauthors=Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE |title= |journal= |volume= |issue= |pages= |year= |pmid=26866211 |doi= |url=}}</ref>
+===Extremities===
+Erysipelas is most commonly found in the [[leg]].<ref name="pmid12386036">{{cite journal |vauthors=Bernard P, Chosidow O, Vaillant L |title=Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial |journal=BMJ |volume=325 |issue=7369 |pages=864 |year=2002 |pmid=12386036 |pmc=129632 |doi= |url=}}</ref>
+*Secondarily, it is found on the face, as well as torso, toes, feet, and hands.<ref name="pmid16319471">{{cite journal |vauthors=Krasagakis K, Samonis G, Maniatakis P, Georgala S, Tosca A |title=Bullous erysipelas: clinical presentation, staphylococcal involvement and methicillin resistance |journal=Dermatology (Basel) |volume=212 |issue=1 |pages=31–5 |year=2006 |pmid=16319471 |doi=10.1159/000089019 |url=}}</ref>
+==Examples of Physical Examination Findings for Erysipelas==
+===Extremities===
+<gallery>
+Image:Erysipelas01.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas02.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas03.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas05.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas06.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas07.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas08.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas10.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas11.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas12.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas13.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas14.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas15.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas16.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas17.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas19.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas20.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas21.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas22.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas25.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas26.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas28.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas29.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas30.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas31.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas32.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas33.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas34.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas35.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas36.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas37.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas38.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+</gallery>
+===Trunk===
+<gallery>
+Image:Erysipelas23.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas24.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+</gallery>
+===Face===
+<gallery>
+Image:Erysipelas04.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas09.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+Image:Erysipelas18.jpg|Erysipelas. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
+</gallery>
-The infection may occur on any part of the skin including the face, arms, fingers, legs and toes, but it tends to favor the extremities. Fat tissue is most susceptible to infection, and facial areas typically around the eyes, ears, and cheeks. Repeated infection of the extremities can lead to chronic swelling ([[lymphadenitis]]).
 ==References==
 {{Reflist|2}}
-[[Category:Needs content]]
-[[Category:Disease]]
-[[Category:Infectious disease]]
 {{WH}}
 {{WS}}
+[[Category:Dermatology]]
+[[Category:FinalQCRequired]]
+[[Category:Emergency medicine]]
+[[Category:Disease]]
+[[Category:Up-To-Date]]
+[[Category:Infectious disease]]

Erysipelas physical examination: Difference between revisions

Latest revision as of 21:39, 29 July 2020

Overview

Physical Examination

Appearance of the Patient

Vital signs

Skin

Extremities

Examples of Physical Examination Findings for Erysipelas

Extremities

Trunk

Face

References

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