Erysipelas
Everything you need to know about Erysipelas - symptoms, causes, treatment options available in Australia, and when to see a doctor. Evidence-based medical information.
What You Need to Know - The Basics
Erysipelas is a skin infection that makes your skin red, swollen, and painful.
The main things to know:
- Your skin might look red and feel warm, like a sunburn.
- It can cause fever and make you feel tired or sick.
- It often affects older adults, but anyone can get it.
- Erysipelas is serious, but doctors can treat it with medicine.
When to see a doctor immediately: If you have a red, swollen area on your skin with a fever or feel very unwell, see a doctor right away.
Doctors can help you get better with treatment, so don't worry too much.
Overview
Erysipelas is an acute bacterial infection of the skin characterised by well-demarcated, raised, erythematous areas, predominantly caused by beta-haemolytic streptococci, particularly Group A Streptococcus [5]. The infection primarily affects the superficial dermal lymphatics, leading to the characteristic clinical presentation. Pathophysiologically, the bacteria invade the skin through minor cuts or abrasions, triggering an inflammatory response that results in the classic signs of erysipelas: redness, swelling, warmth, and pain [3]. The condition is often accompanied by systemic symptoms such as fever and malaise, reflecting the body's immune response to the infection [4].
Statistics and Prevalence in Australia
Current Australian health data does not specifically report the prevalence of erysipelas as a distinct category. Instead, it is often classified under broader categories such as cellulitis or other skin infections in national reports [1]. The Australian Bureau of Statistics (ABS) health prevalence survey from 2022 does not list erysipelas separately, indicating that it is recorded under broader groupings based on ICD-10 codes [1]. The Australian Institute of Health and Welfare (AIHW) also does not provide specific prevalence data for erysipelas, reflecting the need for more granular data collection in this area [2].
Symptoms and Clinical Presentation
Erysipelas typically presents with the sudden onset of a raised, clearly defined, erythematous area, most commonly affecting the face or lower limbs [5]. Early symptoms include fever, chills, and a general feeling of malaise, often preceding the appearance of the skin lesion [4]. As the condition progresses, the affected area becomes more swollen, warm, and painful, with a distinct, raised border that differentiates it from cellulitis, which tends to have less well-defined edges [5]. Red flag symptoms requiring immediate medical attention include rapid spread of the erythema, high fever, and signs of systemic involvement such as confusion or hypotension [4].
Causes and Risk Factors
Erysipelas is primarily caused by infection with Group A Streptococcus, although other beta-haemolytic streptococci can also be involved [5]. The bacteria typically enter the skin through minor breaks or abrasions, which can occur due to trauma, insect bites, or pre-existing skin conditions such as eczema or athlete's foot [3]. Risk factors for erysipelas include lymphoedema, venous insufficiency, obesity, and a history of previous episodes [4]. Immunocompromised individuals and those with chronic illnesses such as diabetes are also at increased risk [3].
Diagnosis
Diagnosis of erysipelas is primarily clinical, based on the characteristic appearance of the skin lesion and associated systemic symptoms [5]. In Australia, the Therapeutic Guidelines (Antibiotic) provide a framework for diagnosis, emphasising the importance of differentiating erysipelas from cellulitis and other skin infections [5]. Laboratory tests, such as blood cultures, may be performed to identify the causative organism, particularly in severe cases or when the diagnosis is uncertain [6]. Imaging studies are generally not required unless there is suspicion of deeper tissue involvement or complications [5].
Treatment Options in Australia
The primary treatment for erysipelas is antibiotic therapy, with penicillin being the first-line agent due to its effectiveness against Group A Streptococcus [5]. For patients with penicillin allergy, alternatives such as erythromycin or clindamycin may be used [6]. In Australia, the Pharmaceutical Benefits Scheme (PBS) provides coverage for these medications, ensuring accessibility for patients [7]. In addition to antibiotics, supportive care, including rest, elevation of the affected limb, and analgesia, is recommended to alleviate symptoms and promote recovery [5]. In severe cases or when complications arise, hospitalisation and intravenous antibiotics may be necessary [6].
Living with Erysipelas
Effective management of erysipelas involves not only treating the acute infection but also addressing underlying risk factors to prevent recurrence [5]. Patients are advised to maintain good skin hygiene, manage chronic conditions such as diabetes, and take measures to prevent skin injuries [4]. Regular follow-up with healthcare providers is important to monitor for potential complications and to ensure that any recurrent episodes are promptly treated [6]. Patient education on recognising early symptoms and seeking timely medical attention is crucial for preventing severe outcomes [5].
Managing this condition is an ongoing process, but many people learn to live well with proper support and care.
Daily management:
- Follow your treatment plan as prescribed
- Keep track of your symptoms and how you're feeling
- Stay in regular contact with your healthcare team
- Learn about your condition so you can make informed decisions
Building your support network:
- Talk to family and friends about your condition
- Consider joining support groups
- Work with healthcare professionals who understand your needs
- Don't hesitate to ask for help when you need it
Self-care strategies:
- Maintain healthy lifestyle habits where possible
- Manage stress and get adequate rest
- Stay as active as your condition allows
- Focus on activities and relationships that bring you joy
Important: With proper management and support, many people with this condition live full and active lives.
Prevention
Preventative strategies for erysipelas focus on reducing the risk of bacterial entry through the skin and managing predisposing conditions [4].
This includes maintaining good skin care, promptly treating any skin injuries or infections, and managing chronic conditions such as lymphoedema and venous insufficiency [5].
For individuals with recurrent erysipelas, prophylactic antibiotics may be considered, particularly if episodes are frequent and severe [6].
Public health initiatives aimed at improving awareness and early recognition of skin infections can also play a role in prevention [4].
Key Takeaways
• Erysipelas is a medical condition that can be effectively managed with proper diagnosis and treatment from healthcare professionals. • Treatment options are available in Australia through Medicare and PBS, making care accessible and affordable for most people. • Early detection and appropriate management can significantly improve outcomes and quality of life for people with this condition.