Erysipelas also can cause swelling and blockage of the superficial vessels of the lymphatic system.
Although potentially serious, erysipelas usually can be treated with antibiotics.
Erysipelas is sometimes referred to as St. Anthony’s Fire because of the fiery appearance of the rash.
DermNet /CC BY-NC-ND
Symptoms of Erysipelas
This photo contains content that some people may find graphic or disturbing.
Erysipelas is characterized by well-demarcated areas of bright red skin that are typically rough, raised, and leathery.
Warmth, pain, and swelling are common as well.
A range of symptoms typically precedes the appearance of the rash by anywhere from four to 48 hours.
They may include:
The appearance of the rash is generally rapid and fast-spreading.
The lymph nodes nearest the infection may also become swollen, as can the skin overlying the lymph nodes.
In some cases, this can lead to a systemic bacterial infection known asbacteremia.
Sepsis is characterized by fever, difficulty breathing, rapid heart rate, and mental confusion.
In rare instances, it can lead to septic shock.
Skin biopsies and cultures generally do not help with the diagnosis.
However, there are key differences between the two skin infections.
Erysipelas affects the upper layers of the skin, whereas cellulitis affects deeper tissues.
Cellulitis is typically slower to develop than erysipelas.
With cellulitis, the affected skin is not nearly as red and rarely has well-defined borders.
Treatment
The standard treatment for erysipelas is antibiotics.
Penicillin is generally the first-line treatment option for streptococcal infections.
Other antibiotics may be used if there is an allergy to penicillin.
Most cases can be treated with oral rather than intravenous (IV) antibiotics.
Treatment is often monitored by marking the borders of the rash with a marker pen.
Doing so can make it easier to see if the rash is receding and the antibiotics are working.
Still, if you have symptoms of erysipelas, you should call your healthcare provider right away.
Quick treatment prevents the worsening of your condition and helps ease discomfort.
Micheal Y, Shaukat E.Erysipelas.
(1999)A Dictionary of the History of Medicine.
2015;15:402. doi:10.1186/s12879-015-1134-2
Stevens DL, Bryant AE.Impetigo, erysipelas and cellulitis.
In: Streptococcus pyogenes: Basic Biology to Clinical Manifestations.
doi:10.12968/hmed.2015.76.8.C114
Brindle R, Williams OM, Barton E, et al.Assessment of antibiotic treatment of cellulitis and erysipelas.
