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Erisepelas (Pathophysiology (Mechanism
Break in superficial skin layer
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Erisepelas
Pathophysiology
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Site
Usually facial, unilateral
Agent
Usually S pyogenes, or S aureus
Diagnosis
Examination
Dermatological examination
Well defined, erythematous facial rash
Warm, swollen, tender
Investigations
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Bloods
FBC, U+E, LFT, cultures
History
DH
Current meds, allergies,
recent abx
SH
Occupation, smoking, alcohol
PMH
Skin disorder, systemic chronic condition,
DM, immunosuppression
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PC/HPC
Site (face), acute onset, red/swollen/tender, spreading, associated fever and malaise
Risk factors
Skin trauma
Ulcer, bite, fungal infection
Ulcers
Lymphoedema
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Clinical
presentation
Rash
Well-defined, erythematous, warm, swollen, tender
Usually affects the face
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Management
Conservative
Information, advice, support
Admit if systemically unwell/complication/immunosuppressed
Mark the affected area
Identify and manage risk factors
Self care (rest, fluids)
Medical
Antibiotics
Indication: all patients
E.g. benpen, phenoxymethylpen, fluclox PO/IV
Analgesia
Indication: pain, fever
Eg. paracetamol, ibuprofen
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