Diagnosis
Erysipelas is usually diagnosed by the clinician looking at the characteristic well-demarcated rash following a history of injury or recognition of one of the risk factors.Tests, if performed, may show a high white cell count, raised CRP or positive blood culture identifying the organism.Erysipelas must be differentiated from herpes zoster, angioedema, contact dermatitis, erythema chronicum migrans of early Lyme disease, gout, septic arthritis, septic bursitis, vasculitis, allergic reaction to an insect bite, acute drug reaction, deep venous thrombosis and diffuse inflammatory carcinoma of the breast. Differentiating from cellulitis
Erysipelas can be distinguished from cellulitis by two particular features; its raised advancing edge and its sharp borders. The redness in cellulitis is not raised and its border is relatively indistinct. Bright redness of erysipelas has been described as a third differentiating feature.Erysipelas does not affect subcutaneous tissue. It does not release pus, only serum or serous fluid. Subcutaneous edema may lead the physician to misdiagnose it as cellulitis. Treatment
Depending on the severity, treatment involves either oral or intravenous antibiotics, using penicillins, clindamycin, or erythromycin. While illness symptoms resolve in a day or two, the skin may take weeks to return to normal. The USA Food and Drug Administration has approved 4 antibiotics-- omadacycline (Nuzyra), oritavancin (Orbactiv), dalbavancin (Dalvance), and tedizolid (Sivextro) --for the treatment of acute bacterial skin and skin structure infections. Because of the risk of reinfection, prophylactic antibiotics are sometimes used after resolution of the initial condition.
Four out of five cases occur on the legs, although historically the face was a more frequent site.Risk factors for developing the disease include
Arteriovenous fistula
Chronic skin conditions such as psoriasis, athletes foot, and eczema
Excising the saphenous vein
Immune deficiency or compromise, such as
Diabetes
Alcoholism
Obesity
Human immunodeficiency virus (HIV)
In newborns, exposure of the umbilical cord and vaccination site injury
Issues in lymph or blood circulation
Leg ulcers
Lymphatic edema
Lymphatic obstruction
Lymphoedema
Nasopharyngeal infection
Nephrotic syndrome
Pregnancy
Previous episode(s) of erysipelas
Toe web intertrigo
Traumatic wounds
Venous insufficiency or disease

Preventative measures
Individuals can take preventative steps to increase the chance they do not catch the disease. Properly cleaning and covering wounds is important for people battling an open wound. Effectively treating athletes foot or eczema if they were the cause for the initial infection will decrease the chance of the infection occurring again. People with diabetes should pay attention to maintaining good foot hygiene. It is also important to follow up with doctors to make sure the disease has not come back or spread. About one-third of people who have had erysipelas will be infected again within three years. Rigorous antibiotics may be needed in the case of recurrent bacterial skin infections. Notable cases
History
It was historically known as St. Anthonys fire. Citations


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