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| Fig. 27.7 Characteristic lesion of erysipelas demonstrating indurated, erythematous plaque with sharply demarcated border. |
Erysipelas, or St. Anthony’s fire, is a form of cellulitis usually caused by b-hemolytic streptococci, rarely by
Staphylococcus aureus. Patients often
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| Fig. 27.8 Streptococcal cellulitis that started with an injury to the index finger. Note associated lymphangitis extending up the arm. |
have a prodrome of malaise, fever, and headache. Typically, erysipelas presents on the face as an erythematous indurated plaque with a sharply demarcated border and a “cliff-drop” edge (Fig. 27-7). In severe cases, the epidermis may become bullous, pustular, or necrotic. Untreated erysipelas can be fatal due to vascular thrombosis, bacteremia, or toxin release. Streptococcal cellulitis is a more generic term that includes erysipelas but also cellulitis that lacks the characteristic cliff-drop border. Known commonly as “blood poisoning,” it is most often found on extremities and is associated with lymphangitis (Fig. 27-8).
