What causes erysipelas?

Written by Zhu Zhu
Dermatology
Updated on September 29, 2024
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Erysipelas is an acute inflammation of the skin and reticular lymphatic vessels. The onset of erysipelas is due to hemolytic streptococci invading the skin and mucosal reticular lymphatic vessels through small wounds in the skin mucosa. Erysipelas commonly occurs on the lower limbs and face, progressing rather quickly, with seldom tissue necrosis, and a tendency for recurrent episodes. The local symptoms include patchy erythema, bright red color, lighter in the center, with clear and slightly raised edges.

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Written by Zhu Zhu
Dermatology
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Erysipelas is caused by what?

The fundamental cause of erysipelas is mainly due to a streptococcal infection of the lymphatic vessels, causing acute non-purulent inflammation. Patients with erysipelas often may have underlying conditions such as athlete's foot, ulcers, or other infectious foci. Erysipelas is prone to develop secondary to ulcers, trauma, or some purulent infections, spreading directly from these primary diseases through the skin, mucous membranes, lymphatic channels, or hematogenous invasion.

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How is erysipelas treated?

Erysipelas is a relatively common disease in our clinical practice, characterized by an infection of the reticular lymphatic vessels. The onset of the disease is sudden and develops rapidly, primarily featuring redness, pain, and swelling of the lower limbs. The treatment of erysipelas first involves elevating the affected limb; it is essential to raise the lower limbs above the level of the heart. Subsequently, local wet compresses are applied, commonly using 50% magnesium sulfate. Finally, antibiotic treatment is administered, including intravenous injections of cephalosporins or penicillin-class drugs, along with fluid replenishment and anti-inflammatory treatment.

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What foods should be avoided with erysipelas?

There are many foods that should be avoided in the case of erysipelas. Firstly, it is advised to avoid spicy and stimulating foods; for example, smoking and alcohol must be refrained from, as well as spicy peppers, garlic, onions, and ginger, which are all considered stimulating and should be avoided. Secondly, after contracting erysipelas, one should avoid certain aggravating foods such as shrimp and sea fish. It is better to eat more foods that help enhance the immune system, and those rich in protein and vitamins.

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How long will it take for erysipelas to heal?

The typical treatment duration for erysipelas is 10 to 14 days. If it is the first outbreak of erysipelas and the treatment is not timely or thorough, or if the treatment duration is insufficient, it is very susceptible to recurrent erysipelas. Treatment for recurrent erysipelas is more challenging, and it may take about three weeks for some people to recover. Especially in elderly patients with swelling in the lower limbs, it is difficult to completely reduce the swelling, which can lead to long-term conditions like elephantiasis. No matter how long any medication is administered, it cannot be completely eliminated, so it is crucial to start treatment gradually and by courses at the onset of the disease. Penicillin is the first choice of medication. For patients allergic to penicillin, cephalosporins or macrolide drugs are the alternatives.

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Can erysipelas be incised and drained?

Erysipelas is different from many infectious diseases in that it should not be incised and drained. Clinically, it is contraindicated to perform incision and drainage on erysipelas because it is an inflammatory non-suppurative infection. As it does not suppurate, incision and drainage would not be effective and might even lead to secondary infections, worsening the condition. Therefore, not only is incision and drainage not recommended for erysipelas, but it is also contraindicated. The treatment of erysipelas should focus on anti-inflammatory methods, possibly involving oral or intravenous medication. (Please take medication under the guidance of a doctor.)