Bacterial Infections: DERMIS Flashcards
Erysipelas Clinical Feature
Involves upper dermis
Confluent, erythematous, sharp raised
edge, warm plaque, well demarcated
Very painful (“St. Anthony’s fire”)
Erysipelas Sites:
face and legs
Erysipelas Systemic symptoms:
fever, chills,
headache, weakness (if present, sign of
more serious infection)
Erysipelas Etiology
GAS
Erysipelas Complications
Scarlet fever, streptococcal
gangrene, fat necrosis, coagulopathy
Spreads via lymphatics
Erysipelas Differential Diagnosis
DVT (less red, less hot, smoother), superficial phlebitis, contact dermatitis, photosensitivity reaction, stasis dermatitis, panniculitis, vasculitis
Erysipelas Investigations
Clinical diagnosis: rarely do skin/blood culture If suspect necrotizing fasciitis: do immediate biopsy and frozen section, histopathology
Erysipelas Management
1st line: penicillin, cloxacillin or cefazolin 2nd line: clindamycin or cephalexin If allergic to penicillin, use erythromycin
Cellulitis Clinical Feature
Involves lower dermis/subcutaneous fat
Unilateral erythematous flat lesion, often with vesicles poorly demarcated, not uniformly raised
Tender
Cellulitis Sites:
commonly on legs
Cellulitis Systemic symptoms
(uncommon): fever,
leukocytosis, lymphadenopathy
Cellulitis Etiology
GAS, S. aureus (large sized
wounds),
H. influenzae (periorbital),
Pasteurella multocida (dog/cat bite)
Cellulitis Complications
Uncommon
Cellulitis Differential Diagnosis
Same as erysipelas
DVT (less red, less hot, smoother), superficial phlebitis, contact dermatitis, photosensitivity reaction, stasis dermatitis, panniculitis, vasculitis
Cellulitis Investigations
Same as erysipelas
Clinical diagnosis: rarely do skin/blood culture If suspect necrotizing fasciitis: do immediate biopsy and frozen section, histopathology
