[9] Erysipelas Flashcards

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1
Q

What is erysipelas?

A

A form of cellulitis involving the dermis and upper subcutaneous tissues

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2
Q

What is the usual cause of erysipelas?

A

Group A streptococcus on scratches or otherwise infected areas

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3
Q

What are some less common causative organisms of erysipelas?

A
  • Strep pneumoniae
  • Klebsiella pneumoniae
  • Haemophilus influenzae
  • Yersina enterocolitica
  • Moraxella
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4
Q

What are the risk factors for erysipelas?

A
  • Elderly, infants and children
  • Immunodeficiency
  • Diabetes
  • Alcoholism
  • Skin ulceration
  • Fungal infections
  • Impaired lymphatic drainage
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5
Q

What areas are most commonly affected in erysipelas?

A
  • Face and legs (most common)

- Arm and upper thighs

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6
Q

What systemic symptoms can often precede skin lesion in erysipelas?

A
  • Malaise
  • Chills
  • High fever
  • Potentially vomiting
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7
Q

How quickly can erysipelas progress?

A

Within 48 hours

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8
Q

What lesion symptoms are often present in erysipelas?

A
  • Pruritus
  • Burning
  • Tenderness
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9
Q

How does the lesion in erysipelas progress?

A

Begins as a small erythematous patch which then becomes a fiery red, indurated, tense and shiny plaque

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10
Q

How do the margins of erysipelas appear?

A

Sharply demarcated and advancing with rapid enlargement over 3-6 days

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11
Q

What sort of lesions can severe erysipelas produce?

A
  • Vesicles
  • Bullae
  • Petechiae
  • Frank necrosis
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12
Q

When does the central erythema start to clear in erysipelas?

A

Within 7-10 days

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13
Q

How is erysipelas investigated?

A

Same as cellulitis

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14
Q

What are the differentials for erysipelas?

A
  • Herpes zoster
  • Angioedema
  • Contact dermatitis
  • Diffuse inflammatory carcinoma of the breast
  • Cellulitis
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15
Q

How is erysipelas managed?

A

Same as cellulitis

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16
Q

What are the potentials complications of erysipelas?

A
  • Sepsis
  • Septic arthritis
  • Recurrence
  • Lymphatic damage
  • Necrotising fasciitis
  • Permanent pigmentary changes