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Erysipelas

Definition

Erysipelas is a type of skin infection. It affects the outermost layer of the skin and the local lymph nodes. 

Causes

Erysipelas is usually caused by group A streptococcus bacteria. The condition may affect both children and adults.

Some conditions that can lead to erysipelas are:

• A cut in the skin

• Problems with drainage through the veins or lymph system

• Skin sores (ulcers)

Symptoms

The infection occurs on the legs or arms most of the time. It may also occur on the face and trunk.

Symptoms of erysipelas may include:

• Fever and chills 

• Skin sore with a sharp raised border. As the infection spreads, the skin is painful, very red, swollen, and warm. Blisters on the skin can form.

Exams and Tests

Erysipelas is diagnosed based on how the skin looks. A biopsy or other tests of the skin are usually not needed.

Treatment

Antibiotics are used to get rid of the infection. If the infection is severe, antibiotics may need to be given through an intravenous (IV) line.

People who have repeated episodes of erysipelas may benefit from long-term antibiotics.

Outlook (Prognosis)

With treatment, the outcome is good. It may take a few weeks for the skin to return to normal. Peeling is common as the skin heals.

Possible Complications

Sometimes the bacteria that cause erysipelas may travel to the blood. This results in a condition called bacteremia. When this happens, the infection may spread to the heart valves, joints, and bones.

Other complications include:

• Return of infection

• Septic shock (a dangerous body-wide infection)

When to Contact a Medical Professional

Contact your health care provider if you have a skin sore or other symptoms of erysipelas.

Prevention

Keep your skin healthy by avoiding dry skin and preventing cuts and scrapes. This may reduce the risk for erysipelas.

References

Bryant AE, Stevens DL. Streptococcus pyogenes. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 197.

Dinulos JGH. Bacterial infections. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 9.

McLarney RM, Sommer LL, Reboli AC, Heymann WR. Bacterial diseases. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 74.

Review Date: 10/13/2024

Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.