Erysipelas

 

Erysipelas is a sharply demarcated superficial dermal bacterial infection, most often caused by invasion of the superficial lymphatics by β-hemolytic group A streptococci (Streptococcus pyogenes) and rarely by S.aureus 

-The most common areas of infection: Legs, followed by the face 

-The most common ages affected: Infants and elderly adults 

-The lesions are red, raised, rapidly advancing with sharply demarcated margins between involved and normal tissues 

-Lesions are painful with bright red edematous indurated appearance giving rise to  “peau d’orange” appearance. 

-Facial lesions can have ‘butterfly’ pattern 

-Milian ear sign: Complete involvement of the ear by erysipelas 

-Nearly always unilateral 

Erysipelas vs.Cellulitis: Erysipelas is painful, raised, indurated plaque with sharply demarcated margins. It is superficial. 

Cellulitis may present with or without purulence