Erysipelas

Introduction Erysipelas is an acute inflammation of the skin and its reticular lymphatic vessels. Occurs in the lower limbs and face. Its clinical manifestations are acute onset, localized flaky rash with clear boundaries, bright red color, and a slight bulge, fading. The surface of the skin is hot and hot, spreading rapidly around, causing burning pain. With high fever, chills and headaches. Although erysipelas is named after "poison", it is not caused by viral infection, but acute suppurative dermal inflammation caused by bacterial infection. The pathogen is a group A beta-hemolytic streptococcus, which is invaded by skin or mucous membranes, but can also be infected by blood.

Cause

The pathogen of erysipelas is group A B-type hemolytic streptococcus, occasionally caused by type C or c-type streptococci. It is often invaded by the damaged part of the skin or mucous membrane, and can also be infected by blood. Therefore, factors such as nasal inflammation, nose, ear, and foot solution often become the cause of erysipelas, and the pathogen can lurk in the lymphatic vessels to cause recurrence. Others such as malnutrition, excessive alcohol abuse, gamma globulin deficiency and renal edema can be the triggering factors for erysipelas.

an examination

Laboratory examinations must be summarized and analyzed based on objective materials and medical examinations, and several possible diagnostics are proposed, and then further examinations are performed to confirm the diagnosis. Such as: blood routine examination of the total number of white blood cells, neutrophils increased; wounds and damaged swabs Gram staining and bacterial culture; lower extremity erysipelas should be performed on the toe dandruff mycology; facial erysipelas should be paranasal sinus radiography .

Differential diagnosis

diagnosis:

Pay attention to the identification of contact dermatitis, cellulitis, and sputum rash:

Cellulitis is a purulent inflammation that specifically affects the deep and subcutaneous tissues of the dermis, most often caused by S. pyogenes or Staphylococcus aureus. Most children are Staphylococcus aureus infections. Cellulitis around diabetic ulcers and hemorrhoid ulcers includes mixed infections of Gram-positive cocci, Gram-negative aerobic bacteria, and anaerobic bacteria. The pathogenic bacteria cause infection by entering the dermis through an external (immunologically normal) or blood-borne pathway (immunosuppressor). Systemic symptoms such as fever, chills and fatigue are common before onset. Red, swollen, hot, and painful plaques appear in the affected area. The redness is most obvious at the center, and the peripheral color gradually becomes lighter, and the boundary with normal skin is unclear. The skin at the edema has a firm feeling and the depression is pressed. In severe cases, there are blisters, necrosis, ulceration and ulceration. Guard lymph nodes can be swollen. Children are good at the head and neck. Most adults are affected by the extremities.

The rash of sputum rash is diverse, and the common one is eczema-like rash. Most occur in the calf, thigh or palm, fingers, erythema, papules, blisters are symmetrically distributed, the affected area is slightly swollen, itchy or tender. If there is a secondary bacterial infection, pustules may appear, and severe cases may have fever, anorexia, superficial lymph node enlargement, and leukocytosis in the blood. In addition to the above performance, it can also be seen that the calf erysipelas rash, urticaria-like plague, ring-shaped erythematous rash and so on. The diagnosis of the disease is not difficult. Most patients have active sputum lesions (the original sputum appears blisters, erosion, exudate, itching), which occurs in the hot season. The rash occurred symmetrically, and the fungus was not detected in the sputum rash, and the sputum skin test was positive.

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