Chronic recurrent erysipelas

Chronic Recurrent Erysipelas

Chronic recurrent erysipelas is a persistent and recurring infection of the upper layer of the skin (dermis) and the underlying soft tissues (subcutaneous tissues). It is caused by a bacterium known as Streptococcus pyogenes (group A Streptococcus), which enters the skin through cuts or breaks. This condition is characterized by episodes of redness, swelling, warmth, and pain in the affected area, often accompanied by fever and chills.

Causes and Risk Factors

The primary cause of chronic recurrent erysipelas is the infection with Streptococcus pyogenes. Factors that increase the risk of developing erysipelas include:

• Lymphedema
• Skin ulcers
• Athlete's foot (Tinea pedis)
• Previous episodes of erysipelas or Cellulitis
• Compromised immune system due to diseases such as diabetes, HIV/AIDS, or cancer
• Obesity

Symptoms

Symptoms of chronic recurrent erysipelas include:

• Sudden onset of high fever and chills
• Red, swollen, and warm area on the skin, often with a clear border
• Pain in the affected area
• Blisters and lesions in severe cases
• Swollen lymph nodes near the affected area

Diagnosis

Diagnosis of chronic recurrent erysipelas is primarily based on the clinical presentation. Laboratory tests may include:

• Blood tests to check for increased white blood cells
• Culture of the wound or blood to identify the bacteria
• Ultrasound to rule out other conditions such as deep vein thrombosis

Treatment

Treatment aims to reduce symptoms, prevent recurrence, and avoid complications. It includes:

• Antibiotics, usually penicillin, to fight the infection
• Pain relief medications
• Rest and elevation of the affected limb to reduce swelling
• In cases of frequent recurrences, long-term antibiotic prophylaxis may be considered

Prevention

Preventive measures include:

• Good skin hygiene
• Prompt treatment of skin wounds and infections
• Managing risk factors such as lymphedema and obesity
• Wearing protective footwear in communal areas to prevent athlete's foot

Complications

If left untreated, chronic recurrent erysipelas can lead to serious complications such as:

• Sepsis
• Lymphangitis
• Chronic swelling due to damage to the lymphatic system (Lymphedema)
• Abscess formation

See Also

• Cellulitis
• Lymphedema
• Sepsis
• Streptococcus pyogenes