Erysipelas

• Superficial cellulitis of skin

• Involves face in at least 80%—spread from nose, facial or dental infection

• Invariably caused by Streptococcus pyogenes

• More common in the elderly

• Abrupt onset

• Rapidly spreading red patch of skin

• Lymphatic and lymph node involvement

• Heat, pain and oedema of lesion

• Systemic effect (e.g. fever, malaise)

• Recurrence is common

Treatment

• Phenoxymethylpenicillin 500 mg (o) qid or IM procaine penicillin once daily for 7–10 d

• Benzylpenicillin 600 mg (IV) 4 hrly (if severe)