Erysipelas is an unpleasant infection of the skin and subcutaneous tissue with tendency to recurrence and further complications.


The disease is caused by streptococcal bacterial infection. Streptococci are a common group of bacteria that cause a large number of diseases (such as tonsillitis, pneumonias, etc.). In erysipelas, the streptococci affect the skin, usually in places of minor wounds, and start local inflammation. The most usual location is the lower extremity.


The manifestations of the disease are both local and general. Local signs can be found at the site of inflammation. The skin turns red, warm to the touch and the affected leg is painful. The infection typically spreads along the subcutaneous lymphatic veins, which is visible as reddish projections. The skin may sometimes react by blister formation. General symptoms include fever, chills, headache and malaise. Untreated erysipelas can easily turn into a dangerous diffuse infection of the skin and subcutaneous tissue (phlegmon) followed by sepsis. Severe forms of erysipelas progressing into septic shock can be easily fatal.


An experienced doctor can diagnose the disease by the naked eye as the local signs are usually well-visible. The blood tests show inflammation signs such as elevated CRP and sedimentation rate. When in doubt, an ultrasound may be done to exclude a deep vein thrombosis.


Antibiotics are the basic method of treatment. Streptococci are very sensitive to penicillin, but even other substances may be used. One particular problem of erysipelas is its recurrence. The infection damages local lymphatic vessels and impairs local lymphatic drainage. This causes frequent lymphedema with the affected leg's swelling and makes the extremity more vulnerable to repeated infections.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources