Erysipelas physical examination

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Differentiating Erysipelas from other Diseases

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S., Kiran Singh, M.D. [2]

Overview

Erysipelas manifests with a characteristic rash, localized on the epidermis. Signs include erythema, edema, bullae, vesicles, and blebs. It usually manifests on the legs, but can also be found on the face, torso, hands, feet, and toes. The patient may also be ill-appearing if there is presence of systemic illness, such as fever, chills, or vomiting.

Physical Examination

Appearance of the Patient

The patient may be ill-appearing if systemic illness such as fever, chills, or vomiting is present.[1]

Vital signs

Fever may be present in erysipelas patients.

Skin

Erysipelas manifests with a characteristic rash, localized on the epidermis, with the following presentation:[2]

Extremities

Erysipelas is most commonly found in the leg.[5]

  • Secondarily, it is found on the face, as well as torso, toes, feet, and hands.[6]

Examples of Physical Examination Findings for Erysipelas

Extremities

Trunk

Face

References

  1. {{cite journal |vauthors=Inghammar M, Rasmussen M, Linder A |title=Recurrent erysipelas--risk factors and clinical presentation |journal=BMC Infect. Dis. |volume=14 |issue= |pages=270 |year=2014 |pmid=24884840 |pmc=4033615 |doi=10.1186
  2. Bläckberg A, Trell K, Rasmussen M (2015). "Erysipelas, a large retrospective study of aetiology and clinical presentation". BMC Infect. Dis. 15: 402. doi:10.1186/s12879-015-1134-2. PMC 4590694. PMID 26424182.
  3. Chong FY, Thirumoorthy T (2008). "Blistering erysipelas: not a rare entity". Singapore Med J. 49 (10): 809–13. PMID 18946616.
  4. Ferretti JJ, Stevens DL, Fischetti VA, Stevens DL, Bryant AE. PMID 26866211. Missing or empty |title= (help)
  5. Bernard P, Chosidow O, Vaillant L (2002). "Oral pristinamycin versus standard penicillin regimen to treat erysipelas in adults: randomised, non-inferiority, open trial". BMJ. 325 (7369): 864. PMC 129632. PMID 12386036.
  6. Krasagakis K, Samonis G, Maniatakis P, Georgala S, Tosca A (2006). "Bullous erysipelas: clinical presentation, staphylococcal involvement and methicillin resistance". Dermatology (Basel). 212 (1): 31–5. doi:10.1159/000089019. PMID 16319471.
  7. 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 7.35 7.36 "Dermatology Atlas".

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