Erysipelas of the Face

A 40-year-old man was hospitalized with the superficial, reddening, and painful facial lesion seen here. Its borders were sharp, and it had developed rapidly. The patient had a temperature of 40°C (104°F) and chills. His erythrocyte sedimentation rate was elevated, and he had neutrophilic leukocytosis.

This is a case of erysipelas, an acute infectious disease of the skin produced by group A β-hemolytic streptococci and usually located on the extensor surfaces of the legs and on the face. The patient displayed the characteristic symptoms of diffuse reddening and swelling of the involved area, fever, and chills.

Erysipelas of the face is dangerous if it begins on the bridge of the nose and spreads laterally, causing edema of the eyelids. The diagnosis is made clinically, and treatment consists of penicillin (or erythromycin if the patient cannot take penicillin). This photo was sent by Drs N.K. Akritidis, T. Papaxanthis, and G Mantzios of Ioannina, Greece.