what it is, the causes, complications, and treatment

When someone asks you for an example of a disease that has been reduced in number over the years due to science and health conditions, remember to mention erysipelas, a disease caused by infection by bacteria in surface areas. skin. Since the discovery of the antibiotic and improved public health, its incidence has decreased.

This disease can affect people of all ages, especially the elderly, and is a little more common among women. The reason for this is that these groups are most affected by beno-diseases.

In general, it needs a fixation, which can be a pain or a fingertip between the fingers. However, in some situations, it appears for no apparent reason.

When any of your symptoms appear, you should not wait for your doctor’s advice. This is because the treatment should be immediate, which is done with antibiotics.

Depending on the patient’s general health condition and the severity of the condition, the medicine may be given orally or intravenously. Although the response and recovery is relatively rapid, erysipelas is a recurrent disease over time. In such cases, preventive therapy may be indicated.

Understand what erysipelas is

It is an infectious condition that affects the skin and skin tissues (dermis and epidermis).
In general, erysipelas cannot be distinguished from cellulite, which is also a bacterial infection. The difference is that it settles in the deepest part of the skin, even reaching the subcutaneous fat, which comes under the skin.

It is important to know that cellulite associated with erysipelas should not be confused with what we call cellulite, which is aesthetically pleasing. Thus, some doctors may say that the disease is erysipelas-cellulite complex.

Why does it happen?

Erysipelas is caused by a bacterial infection, mainly due to a group of bacteria called Streptococcusalthough others are also related, such as Staphylococcus aureus.

In general, the skin is an effective barrier against these microorganisms, but they can spread quickly when they encounter a “passage”, such as a wound.

In addition to skin lesions, other factors may facilitate this process:

  • They have had erysipelas before
  • surgical cuts
  • Chilblains and mycoses
  • Bite of insects
  • Allergies (such as eczema)
  • Immune-reducing conditions (uncontrolled diabetes, HIV, use of certain medications)
  • Varicose veins and other benign problems (real chronic insufficiency)
  • Edema or lymphatic obstruction
  • Nephrotic syndrome
  • Obesity
  • Internal drug abuse
  • liver disease
  • Pregnancy

Is erysipelas contagious?

According to the experts consulted, erysipelas is caused by bacteria and is therefore considered a contagious disease. However, in general, the bacteria associated with it alone are not able to cause the disease.

In most cases, erysipelas must have one or more predisposing factors, such as those mentioned above.

Who needs more attention?

Erysipelas can affect men, women, and even children, but it is a little more common in women — perhaps due to hormonal factors that tend to cause problems like varicose veins — and in the elderly, as they accumulate skin fragility and risk factors such as diabetes. . , well problems and obesity.

Learn to recognize the symptoms

Erysipelas usually appears on the legs, but can also appear on other parts of the body, such as the face, arms, or torso. Typical presentations of the disease include:

Systemic symptoms (usually affects the body 48 hours before the appearance of the skin)

  • general discomfort
  • Moderate and high fever
  • Chills
  • Enlarged lymph nodes (tongues)

local symptoms

  • Red spot on the skin (starts small, limited and unilateral)
  • Hot
  • Mine
  • Inflammation
  • Local itching and burning
  • Blisters and vesicles (although they do not appear in some cases)

When to seek medical help?

Expert advice is that when observing skin changes, such as the appearance of a reddish and bright color, along with local heat or pain, you should be aware of the possible evolution of the condition.

If these conditions persist or worsen, you should seek medical attention. When fever and general discomfort are added, the action should be immediate.

Generally, the primary care for patients with erysipelas is an emergency doctor (who may be a general practitioner). In fact, in most cases the diagnosis is urgent and cannot wait for a specialist referral or appointment.

However, the best professionals to evaluate and treat erysipelas are a dermatologist, infectologist and angiologist (vascular surgery).

How is the diagnosis made?

At the time of the appointment, the doctor will hear your complaint, take your health history, and perform a physical examination. This will look for not only the affected area, but also the presence of an “entrance door” (such as a shoe ceiling or skin wound), which will not always be present.

The diagnosis will be based on this information and is called a clinical diagnosis.

Among patients with more severe conditions or debilitating illnesses, a blood test may be ordered to identify sepsis (a general infection) or something more serious.

How is the treatment done?

Dermatologist Egon Daxbacher, coordinator of SBD’s Department of Infectious and Parasitic Diseases, says the goal of treatment is to fight the infection by using antibiotics orally or intravenously (in more severe cases).

“The choice of medication varies and it depends on whether the patient has an associated disease, or has recently taken antibiotics,” he says.

In general, the treatment lasts between 7 and 14 days and, after 48 hours, the overall improvement of the patient can be noticed. Over the next 10 to 15 days, a full recovery is expected.

To increase patient comfort, foot lift (if affected area) and massage may be indicated. Although these measures may not be enough to treat erysipelas, they do relieve symptoms.

How can wounds be treated at home?

For the most part, erysipelas does not cause skin lesions, and redness, edema (swelling) and heat are more common in the region.

However, some people may have blisters. In these cases, it is up to the doctor to guide the necessary care, as well as the best way to sanitize and dress them.

Find out about possible complications

They are considered rare, especially when there is early diagnosis and proper treatment. In rare cases, they are limited to abscesses, pneumonia, meningitis, thrombophlebitis, and protection.

“The most frightening of these, however, is sepsis, although rare, which can occur in more serious patients and in more vulnerable organisms,” says dermatologist Ana Lúcia França da Costa, a professor at UFPI.

Can erysipelas reappear?

Yes. The literature on the disease shows that recurrence can occur in between 20% and 50% of cases, even after proper treatment and complete recovery. Helena Barbosa Lugão, a dermatologist, Hansenologist, and HCFMRP-USP tutor, says this is mostly due to a lack of control over risk factors.

The doctor added that “because the risk of damaging the lymphatic system is another possible consequence of lymphedema, which is the accumulation of lymph in the tissues and promotes inflammation. This in turn increases the risk of developing a new erysipelas. one”.

For patients with this feature, preventive treatment (prophylaxis) with antibiotics may be indicated to prevent recurrence. The literature on this practice indicates a 69% reduction in the risk of recurrence. The data are from Cochran.

Can it be prevented?

Yes, and the secret is to have a healthy lifestyle to control various risk factors related to erysipelas (varicose veins, diabetes, obesity …).

Other measures include good hygiene practices, such as thoroughly cleaning and drying the feet and skin, preventing wounds or insect bites, and the use of comfortable shoes and socks that protect against injury.

If you have a cut on your skin, wash it with soap and water and cover the area with a bandage to prevent it from being exposed. Also, avoid using antibacterial soaps without medical advice.

Sources: Ana Lúcia França da Costadermatologist and professor at UFPI (Federal University of Piauí) and member of the clinical staff of the University Hospital of the same organization that integrates the Ebserh network (Brazilian Hospital Services Company); Stay Daxbacherdermatologist and coordinator of the Department of Infectious and Parasitic Diseases of the SBD (Brasilia Dermatology Association); Helena Barbosa LugãoSBD dermatologist specialist, leprosy therapist and HCFMRP-USP preceptor (Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo), also working for Ribeirão Preto City Council. Medical Review: Helena Barbosa Lugão.

References: SBD (Brazilian Dermatological Society); Michael Y, Shaukat NM. Erysipelas. [Atualizado em 2021 Aug 11]. Here: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2022-. Available here: https://www.ncbi.nlm.nih.gov/books/NBK532247/.

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