Thursday, April 26, 2012


Erysipelas is an infection of the soft tissues, and is generally caused by Group A Beta Hemolytic Streptococcus (GABHS).  It is characterized usually by fever and chills (mediated by the exotoxin secreted by the strep), bright erythema at the site of infection and a peau d'orange (skin of the orange) appearance because the strep toxins cause congestion in the lymphatics, which in turn cause intense edema.  The small dimples are from the hair follicles not being as distensible as the non-adnexal skin.

Usually a result of a small break in the skin, the erysipelas can advance rapidly, and particularly on the face, can lead to sepsis and death.  This guy either gets a bed in the hospital or a spot in the morgue.  I vote for hospitalization.

I gave credit for any of the facial cellulitides, including periorbital cellulitis, and hospitalization/IV abx.
And for those of you who weighed in on the nail question, yes it was Lovibond.  

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