Sweltering inflammation

Erysipelas is an infectious skin disease caused by pathogenic hemolytic streptococcus. Inflammatory processes of the mucous membranes caused by this streptococcus have their own nosological names - scarlet fever, blepharitis, etc.

The introduction of streptococcus into the skin most often occurs exogenously through wounds, abrasions, scratches, ulcers and pustules, the process is usually local and does not cause significant changes in the patient's condition. Less often, the spread occurs lymphogenously from foci of chronic infection or lymph nodes, which, as a rule, causes the development of an extensive process that can occupy an entire anatomical area (face, limb, trunk, etc.), is accompanied by purulent-resorptive fever, often has hyperergic manifestations. Rarely, there is a hematogenous route of infection spread in streptococcal sepsis, usually in severe scarlet fever, when the entire skin is involved in the process or multiple metastatic foci are formed, this process should be considered as septicopyemia.

By origin, there are: primary erysipelas; repeated, when it occurs in a different place than the first time; recurrent with the formation of the process in the same place, it should be considered as an infectious-allergic form. By the nature of local changes, there are erythematous, bullous, pustular, hemorrhagic, phlegmonous, necrotic (gangrenous) and mixed erysipelas.

Symptoms of erysipelas begin with a prodrome, which in most cases lasts 3-5 days: fatigue, weakness, chills, headache, a feeling of distension in the area of infection, regional lymph nodes enlarge, body temperature may increase, up to fever.

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How does erysipelas manifest itself?

Erysipelas begins acutely. Local manifestations begin and in most cases end with the erythematous form: pronounced hyperemia, edema and infiltration of the skin appear, often of irregular shape with clearly defined edges, sometimes a ridge of edematous skin forms along the edge of hyperemia, the hyperemia zone is sharply painful, more towards the edge, the skin is hot to the touch. In the bullous form, vesicles filled with serous contents form in the hyperemia zone. If the vesicles are filled with turbid exudate, we are talking about the pustular form; in the hemorrhagic form of erysipelas, the vesicles are filled with hemorrhagic exudate. The phlegmonous form develops with the involvement of subcutaneous tissue in the inflammatory process, but unlike true phlegmon, in which hyperemia with blurred edges and maximum pain in the center, fluctuations due to the accumulation of pus are not noted. Necrotic erysipelas is accompanied by the formation of black necrotic areas in the hyperemic area, but unlike anthrax, this area is extremely painful.