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| {{Infobox_Disease
| | #REDIRECT [[Erysipelas]] |
| | Name = Erysipelas
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| | Image = Erysipel.JPG
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| | Caption = Erysipelas
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| | DiseasesDB = 4428
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| | ICD10 = {{ICD10|A|46|0|a|30}}
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| | ICD9 = {{ICD9|035}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus = 000618
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| | eMedicineSubj = derm
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| | eMedicineTopic = 129
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| | MeshID = D004886
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| }}
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| {{SI}}
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| {{CMG}}
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| '''Erysipelas''' ([[Greek language|Greek]] ερυσίπελας - ''red skin'') is an acute [[streptococcus]] [[bacteria]]l infection of the [[dermis]], resulting in inflammation and characteristically extending into underlying fat tissue. This disease is also known as [[Saint Anthony's fire]].
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| ==Risk factors==
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| This disease is most common among the elderly, infants, and children. People with [[immune deficiency]], [[diabetes]], [[alcoholism]], skin [[ulceration]], [[fungal infections]] and impaired [[lymph node|lymph]]atic drainage (e.g., after [[mastectomy]], pelvic surgery, [[Bypass (surgical)|bypass]] grafting) are also at increased risk.
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| ==Signs and symptoms==
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| Patients typically develop symptoms including high [[fevers]], [[tremor|shaking]], [[chills]], [[fatigue (physical)|fatigue]], [[headaches]], [[vomiting]], and general illness within 48 hours of the initial infection. 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.
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| 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]]).
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| ==Etiology==
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| Most cases of erysipelas are due to ''[[Streptococcus pyogenes]]'' (also known as [[group A streptococci]]), although non-group A streptococci can also be the causative agent. Historically, the face was most affected; today the legs are affected most often. <ref>See eMedicine link</ref>
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| Erysipelas infections can enter the skin through minor trauma, [[eczema]], surgical incisions and ulcers, and often originate from strep bacteria in the subject's own nasal passages.
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| ==Diagnosis==
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| This disease is mainly diagnosed by the appearance of the rash and its characteristics. Blood cultures are unreliable for diagnosis of the disease, but may be used to test for [[sepsis]]. Erysipelas must be differentiated from [[herpes zoster]], [[angioedema]], [[contact dermatitis]], and diffuse inflammatory [[carcinoma]] of the breast.
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| Erysipelas can be distinguished from [[cellulitis]] by its raised advancing edges and sharp borders.
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| Elevation of the [[antistreptolysin]] O titre occurs after around 10 days of illness.
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| ==Treatment==
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| Depending on the severity, treatment involves either oral or intravenous antibiotics, using [[penicillin]]s, [[clindamycin]] or [[erythromycin]]. While illness symptoms resolve in a day or two, the skin may take weeks to return to normal.
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| Because of the risk of reinfection, prophylactic antibiotics are sometimes used after resolution of the initial condition. However, this approach does not always stop reinfection.<ref name="pmid17387234">{{cite journal |author=Koster JB, Kullberg BJ, van der Meer JW |title=Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies |journal=The Netherlands journal of medicine |volume=65 |issue=3 |pages=89–94 |year=2007 |pmid=17387234 |doi=}}</ref>
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| ==Complications==
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| *Spread of infection to other areas of body through the bloodstream ([[bacteremia]]), including septic arthritis and infective [[endocarditis]] (heart valves).
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| *[[Septic shock]].
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| *Recurrence of infection – Erysipelas can recur in 18-30% of cases even after antibiotic treatment.
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| *Lymphatic damage
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| *[[Necrotizing fasciitis]] -- AKA "the flesh-eating bug." A potentially-deadly exacerbation of the infection if it spreads to deeper tissue.
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| ==Deaths==
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| *[[Father Solanus Casey, Capuchin monk and 20th Century spiritual figure, 1870-1957, USA]]<ref>Wollenweber, Brother Leo (2002) "Meet Solanus Casey", St. Anthony Messanger Press, Cincinnati, Ohio Page 107 ISBN 1-56955-281-9</ref>
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| *[[Charles Lamb]]
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| *[[Princess Amelia of the United Kingdom|Princess Amelia]], daughter of [[George III]]
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| *[[Miller Huggins]], manager of the [[New York Yankees]] from [[1918]] until his death in [[1929]]
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| *[[James A. Bailey]]
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| *[[Anne of Great Britain]]
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| *[[William H. Crawford]], [[Secretary of the Treasury]] in the administration of President [[James Monroe]].
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| *[[John Stuart Mill]]; political philosopher most famous for his work ''[[On Liberty]]''<ref name="isbn0-521-62024-4">{{cite book |author=Capaldi, Nicholas |title=John Stuart Mill: a biography |publisher=Cambridge University Press |location=Cambridge, UK |year=2004 |pages=356 |isbn=0-521-62024-4 |oclc= |doi=}}</ref>
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| *[[Judith of Swabia]], daughter of the Holy Roman Emperor [[Henry III, Holy Roman Emperor|Henry III]]
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| ==In animals==
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| Erysipelas is also the name given to an infection in animals caused by the [[bacterium]] ''[[Erysipelothrix rhusiopathiae]]''. Infection by ''Erysipelothrix rhusiopathiae'' in humans is a separate entity known as [[erysipeloid]].
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| ==Footnotes==
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| {{reflist|2}}
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| ==External links==
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| *[http://www.healthinplainenglish.com/health/skin/erysipelas/index.htm Erysipelas Overview] Health in Plain English - with pictures
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| {{Bacterial diseases}}
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| [[Category:Dermatology]]
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| [[Category:Bacterial diseases]]
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| <br>
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| [[bs:Erizipel]]
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| [[cs:Erysipel]]
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| [[de:Erysipel]]
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| [[es:Erisipela]]
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| [[eo:Erizipelo]]
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| [[fr:Érysipèle]]
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| [[hr:Erizipel]]
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| [[it:Erisipela]]
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| [[lt:Rožė (liga)]]
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| [[nl:Erysipelas]]
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| [[no:Erysipelas]] | |
| [[pl:Róża (choroba)]]
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| [[pt:Erisipela]]
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| [[ru:Рожа (болезнь)]]
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| [[scn:Risibbella]]
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| [[sr:Црвени ветар]]
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| [[fi:Ruusu (sairaus)]]
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| [[sv:Rosfeber]]
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