Erysipelas or erysipelas is a bacterial infection in the middle layer of the skin (dermis layer) and lymph channels in the skin. This infection is most often caused by the Streptococcus bacteria . If not treated immediately, erysipelas can cause skin tissue death (gangrene).

The dermis layer is the second layer of the skin. In erysipelas, the dermis layer becomes infected and causes a red rash. This rash can appear anywhere on the body, but is more common on the face, legs, and arms.

Erysipelas can occur in all age groups, including children and the elderly. Although it can happen to anyone, this infection is not contagious, because erysipelas does not occur on the outermost surface of the skin, like impetigo .

Erysipelas and cellulitis are often considered the same, even though the sites of infection in the two conditions are different. Erysipelas infection occurs in the dermis layer of the skin, while cellulitis infection occurs in the deeper layers of the skin and surrounding tissues.

In addition, the rash with erysipelas is generally lighter in color and has more defined boundaries than the cellulitis rash. However, these two infections can occur together.

Causes of Erysipelas

Erysipelas is generally caused by group A Streptococcus bacteria , namely Streptococcus pyogenes . These bacteria can grow and thrive on the skin that is injured, such as wounds from surgery, open wounds, burns, and insect bites .

As mentioned, erysipelas can affect anyone. However, there are several factors that can increase a person's risk of developing erysipelas, namely:

  • Cuts on the skin, such as surgical wounds, cuts, or needle punctures
  • Blockage of the lymph vessels ( lymphedema )
  • Impaired blood flow in the veins
  • Eczema or atopic dermatitis
  • Water fleas
  • Diabetes
  • Weak immune system, such as in people with HIV/AIDS infection
  • Pregnancy
  • Overweight or obesity
  • Excessive consumption of alcoholic beverages
  • Radiation therapy ( radiotherapy ) or chemotherapy
  • Previous history of erysipelas

Erysipelas Symptoms

The main symptom of erysipelas is a reddish skin rash that feels rougher and protrudes from the surrounding skin, especially on the face, legs, and arms. The rash is warm, painful, and may form blisters.

This rash can also be accompanied by other symptoms, such as:

  • Fever and chills
  • Body feels tired
  • Headache
  • Nausea and vomiting

When to see a doctor

Immediately consult a doctor if you experience the symptoms mentioned above. Early examination and treatment is needed to prevent the condition from deteriorating into cellulitis or gangrene which can lead to amputation.

Diagnosis of Erysipelas

To diagnose erysipelas, the doctor will ask questions and answers about the patient's symptoms, medical history, history of injuries, and operations. After that, the doctor will do a physical examination, especially where the rash appears. A physical examination is usually carried out using a magnifying glass and feeling the rash.

Generally, doctors can immediately diagnose erysipelas through a physical examination. However, to confirm the condition, the doctor will perform a blood test and a skin biopsy to detect the bacteria that causes erysipelas.

Erysipelas Treatment

Erysipelas treatment aims to treat the infection, relieve symptoms, and prevent complications. Treatment is also carried out according to the severity of the infection and the patient's condition.

If the patient has severe symptoms, the doctor will recommend hospitalization. The doctor will give antibiotics to the patient by injection or infusion to treat the infection. Meanwhile, if the symptoms are still relatively mild, the doctor will prescribe drinking antibiotics without having to suggest hospitalization.

Some of the antibiotics that doctors can give are:

  • Penicillin
  • Erythromycin
  • Ceftriaxone
  • Clindamycin
  • Sulfamethoxazole or trimethoprim
  • Doxycycline
  • Vancomycin

Apart from using antibiotics, the doctor will also advise the patient to do the following things to speed up the healing process:

  • Do bed rest ( bed rest ) by supporting the legs using pillows to reduce swelling
  • Cold compresses for rashes to reduce pain
  • Take pain medication if needed
  • Drink enough to avoid dehydration

If the patient has athlete's foot , the doctor can prescribe antifungal medication. This is because athlete's foot can cause the development of bacteria that cause erysipelas.

Erysipelas complications

Although it rarely occurs, erysipelas can cause complications in the form of bacteremia , which is a condition when there are bacteria in the blood. If bacteremia occurs, the infection can spread to other parts of the body, such as the bones, heart valves , or joints. Bacteremia can also cause sepsis .

In addition to bacteremia, erysipelas can cause other complications, namely:

  • Death of skin tissue ( gangrene )
  • Inflammation of the veins ( thrombophlebitis )
  • Recurring infection
  • Post-streptococcal glomerulonephritis , namely kidney disorders that occur after Streptococcus infection

Erysipelas Prevention

The best way to prevent erysipelas is to reduce the risk of infection. Some things that can be done are:

  • Wash hands with soap and running water regularly
  • Using skin moisturizer to prevent dry skin so that the skin is not easily scratched
  • Do not scratch the skin, especially on injured skin
  • Carry out routine checks to the doctor if you suffer from a disease that can weaken your immune system, such as diabetes or HIV/AIDS
  • Maintain body weight to remain ideal

If you have erysipelas, take antibiotics as directed by your doctor. In addition to treating the infection itself, the correct consumption of antibiotics aims to reduce the risk of erysipelas recurrence and prevent antibiotic resistance .

Back to blog