Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Jan 14, 2012.
what is your medical diagnosis for this case ?
ulcus cruris ,trombosis
Erysipelas The Acute Streptococcus Bacterial Infection Of The Deep Epidermis With Lymphatic Spread
Answer : Erysipelas
Erysipelas versus Cellulitis
Cellulitis and erysipelas manifest as areas of skin erythema, edema, and warmth. They differ in that erysipelas involves the upper dermis and superficial lymphatics, whereas cellulitis involves the deeper dermis and subcutaneous fat. As a result, erysipelas has more distinctive anatomic features than cellulitis; erysipelas lesions are raised above the level of surrounding skin, and there is a clear line of demarcation between involved and uninvolved tissue. Classic descriptions of erysipelas note "butterfly" involvement of the face. Involvement of the ear (Milian's ear sign) is a distinguishing feature for erysipelas, since this region does not contain deeper dermis tissue. In addition, patients with erysipelas tend to have acute onset of symptoms with systemic manifestations including fever and chills; patients with cellulitis tend to have a more indolent course with development of localized symptoms over a few days' time. Cellulitis may present with or without purulent drainage or exudate.
ref - Cellulitis and erysipelas
This name is given to a distinctive form of cellulitis, in which infection tracks along the fascial planes, causing thrombosis of blood vessels running through the fascia with resulting necrosis of the skin, subcutaneous fat and even muscle.
ref - Rook's Textbook of Dermatology
MX - common to all is systemic drugs and surgery comes in focus, the deeper u go.
And here's one from my side - people with cellulite are more likely to develop cellulitis :idea:
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