Erysipelas

Question 1

Features

Answer 1

Superficial cellulitis of skin

Involves face in at least 80%

• —spread from nose, facial or dental infection

Invariably caused by Streptococcus pyogenes

More common in the elderly

Abrupt onset

Rapidly spreading red patch of skin

Lymphatic and lymph node involvement

Heat, pain and oedema of lesion

Systemic effect (e.g. fever, malaise)

Recurrence is common

Question 2

Treatment

Answer 2

Phenoxymethylpenicillin 500 mg (o) qid

• or IM procaine penicillin once daily for 7–10 d

Benzylpenicillin 600 mg (IV) 4 hrly (if severe)