Erysipelas (a.k.a. St. Anthony’s fire) is an acute skin infection caused by group A Streptococcus bacteria which typically affects the face, ears, and lower legs. It is a superficial form of cellulitis in that the infection is closer to the skin surface as opposed to a deeper layer of the skin. Following infection, a rash forms on the affected skin which is well demarcated and typically red, warm, painful, and swollen. It is small initially but expands quickly. The rash may also be dimpled or blistered.
The appearance of the rash is abrupt and is preceded by symptoms such as high fever, chills, vomiting, and headaches. These symptoms typically occur approximately 24 to 48 hours prior to the onset of the rash. In the past, the face was most vulnerable but it now appears more commonly on the legs.
Erysipelas is a condition which most commonly affects infants, children, and the elderly. People with immune deficiency (e.g. those infected by the HIV), skin ulceration, and fungal infections are also susceptible to infection. Other risk factors include cuts and abrasions on the skin. Dermatologists diagnose Erysipelas by examining but blood cultures may be analyzed as well to rule out sepsis. Skin biopsies are usually not helpful.
Treatment
Treatment of Erysipelas is normally through antibiotics such as penicillin, erythromycin, dicloxacillin, and cephalosporins. Treatment is normally continued for around 10-14 days and signs of illness relent within a day or two. The skin may still take a few weeks to heal. Erysipelas recurs in about one third of cases, in which case long-term treatment with antibiotics may be necessary.
