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Erysipelas
Last reviewed: 17.10.2021
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Erysipelas is an infectious disease of the skin caused by pathogenic hemolytic streptococcus. Inflammatory processes of the mucous membranes caused by this streptococcus have their own nosological names - scarlet fever, blepharitis, etc.
The introduction of streptococcus into the skin most often occurs exogenously through wounds, abrasions, scratching, ulcers and pustules, the process is usually of a local nature and does not cause significant changes in the patient's condition. Less common is lymphogenous from the foci of chronic infection or lymph nodes, which, as a rule, causes the development of an extensive process that can occupy the whole anatomical area (face, limb, trunk, etc.), accompanied by purulent-resorptive fever, often has hyperergic manifestations. Rarely does the hematogenous pathway of infection spread with streptococcal sepsis, usually with severe scarlet fever, when the whole skin is involved or multiple metastatic foci are formed, this process should be considered as septicopyemia.
By origin distinguish: the primary erysipelas inflammation; repeated when it occurs elsewhere than the first time; relapsing with the formation of the process in the same place, it should be considered as an infectious-allergic form. By the nature of local changes, erythematous, bullous, pustular, hemorrhagic, phlegmonous, necrotic (gangrenous) and mixed erysipelas are distinguished.
Symptoms of erysipelas begin with a prodrome, which in most cases is 3-5 days: fatigue, frustration, chills, headache, a feeling of bursting in the zone of infection, regional lymph nodes increase, body temperature can rise, right up to fever.
[How does erysipelas manifest?
Erysipelas begins acutely. Local manifestations begin and, in most cases, end with the erythematous form: pronounced hyperemia, edema and infiltration of the skin, often irregular in shape with clearly defined edges, sometimes a rim of edematous skin forms on the edge of hyperemia, the zone of hyperemia is sharply painful, more to the edge, skin hot on touch. When the bullous form in the zone of hyperemia, bubbles are formed, filled with serous contents. If the vesicles are filled with turbid exudate, it is a pustular form; with hemorrhagic form of erysipelas, the vesicles are filled with hemorrhagic exudate. The phlegmonous form develops when subcutaneous tissue is involved in the inflammatory process, but unlike the true phlegmon, in which hyperemia with diffuse margins and maximum morbidity in the center, fluctuations due to accumulation of pus are not observed. Necrotic erysipelatous inflammation is accompanied by the formation of black areas in the hyperemia region, but unlike the anthrax, this zone is sharply painful.