ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. A26A46ArtikelübersichtErysipel
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Erysipelas, also called Wundrose or Rotlauf, is a bacterial skin disease. Through small wounds on the body surface, bacteria can penetrate into deeper skin layers and multiply there. The body tries to fight these bacteria, and it comes to an inflammation of the skin. The result is a flat, usually sharply defined redness and painful swelling. Since the inflammation spreads around the entry point of the pathogen, the appearance reminds of a rose flower, hence the name Wundrose.
Diseases such as erysipelas can also form blisters and pustules in the affected areas of the skin and nearby lymph nodes, such as lymph nodes, can be affected. in the knee or the groin, swell. The affected people feel sick and develop a fever, but they often notice the cuticle only a few days later due to pain and swelling.
Generally, bacteria can affect every area of the skin. Often the cuticle occurs on the leg or sometimes on the face. The bacteria are usually streptococci (A, C, G), more rarely staphylococci, both of which respond well to antibiotics. The erysipelas are therefore treatable quickly, but must be recognized correctly and early, because the infection can also spread further in the body and lead to sepsis, inflammation of the heart (endocarditis), or nephritis (glomerulonephritis). It is also important to differentiate the erysipelas from other diseases, since it can also be confused with thrombosis, other inflammatory processes or even a tumor.
Even after successful treatment, erysipelas can recur within a few months (recurrence). This is unfortunately very typical, because people with skin injuries or skin diseases again and again provide targets for bacteria. The pathogens are particularly easy when the immune system is weakened. Therefore, especially older people are affected by a Wundrose (erysipelas).
Many people fear that an erysipelas is contagious. However, erysipelas do not spread from one person to another. Many other diseases caused by the same bacterium (mainly Streptococcus pyogenes) are very contagious. For example, scarlet fever, or a skin condition called impetigo contagiosa. However, in these cases the infection pathways and the spread of the pathogen are different. In 20 percent of all people Streptococcus pyogenes already lives on the skin and mucous membranes, without making those affected sick. Only when it breaks through the skin barrier, it can lead to a disease.To the table of contents
The main symptom of erysipelas is the typical, usually sharply defined painful swelling of the skin. However, it often happens that the redness of the skin does not appear as the first symptom, or causes most discomfort. Sometimes patients even go to the doctor for unspecific discomfort without having discovered the lesion. Already at the beginning of the infection it can come to fever, headache and a strong sense of illness. The redness does not have to be seen at this time, but the skin often burns or hurts. Shortly thereafter, the swollen, red Wundrose forms around the entry point of the bacteria. Typical signs of the skin area affected by the Wundrose are:
- Swelling (edema)
- flat redness
- Swelling of nearby lymph nodes
Erysipelas: causes and risk factors
The Wundrose is a bacterial inflammation of various layers of skin, which spreads to all sides and thus creates the reddish inflammatory area. Mainly the erysipelas are triggered by a certain Streptokokkenart: Streptokokkus pyogenes. But also other streptococci, or in some cases staphylococci (another genus of bacteria), can cause a sore throat. They are, however, much rarer.
In most people, streptococci naturally occur on the skin and on the mucous membranes without causing any discomfort. The skin acts as a natural barrier that protects us from diseases and infections. The body surface is populated by bacteria that do not make us sick because they can not penetrate the body, on the contrary, they often prevent even more dangerous bacteria from attacking the skin. However, if there is a skin injury, these bacteria can penetrate into deeper layers of the tissue and it comes to an inflammation.
It is important to understand that the sole contact with the bacterium does not make you sick, but there must always be a skin lesion. This injury can be a scratch, a bruise, or cut, but also, for example, dry, chapped skin, or a foot fungus. Once the protective function of the skin is impaired, bacteria can penetrate the body surface.
Beneficial factors for an erysipelas
Diseases that damage the skin can promote a wound rose. A typical example is lymphedema after breast surgery. Breast cancer, in addition to the tumor, also cuts or removes important lymphatics that normally drain tissue. This fluid now remains in the tissue and the skin swells. This makes it easier for bacteria to penetrate the skin and cause inflammation. Swelling (edema) therefore promotes the formation of an erysipelas. Causes of swelling or fluid in the tissue can be:
- heart failure
- kidney damage
- varicose veins
- Circulatory disorders
Skin disorders that affect protective function are also risk factors for an erysipelas:
- skin fungus
- dry, chapped skin
- minor injuries to the skin or the nail bed
Even if bacteria can penetrate the top layer of skin, it often creates the immune system to quickly eliminate these bacteria and heal the skin injury. A functioning immune system and an undisturbed blood supply to the skin and the underlying tissue is therefore very important. Some diseases or therapies interfere with the blood supply or suppress the immune system, so that in these cases bacteria can spread undisturbed in the tissue. These include, for example:
- Diabetes mellitus
- Chemotherapy for cancer
- alcohol addiction
- HIV / AIDS
Especially children and the elderly are more often affected by red rot. On the one hand because of their less efficient immune system, on the other hand, because they hurt faster, and thus no skin barrier is present.To the table of contents
Erysipelas: examinations and diagnosis
Erysipelas is a diagnosis that the doctor already makes in appearance and symptoms. Depending on the stage of the disease, general indications for an infection can also be found. An increase in temperature (fever), changes in the rate of erythrocyte sedimentation, and other changes in blood levels help the physician estimate the physical response and severity of the infection. Wound swabs for pathogen detection are unfortunately rarely helpful in erysipelas and bacterial cultures can only be obtained from the blood when the bacteria have already penetrated into the bloodstream in large numbers.
It is particularly important to look for the portal of entry of the bacteria. Pimples or small tears of the skin in the corners of the mouth (rhagades), for example, are often responsible for a facial rose.
In addition, the doctor must clarify which risk factors or diseases favor the emergence of an erysipelas.
The difficulty in diagnosing an erysipelas is to rule out other causes. A variety of disorders can cause redness and swelling of the skin and each requires a specific therapy. Therefore, it is important to know exactly what disease is present in the patient. In this situation, the doctor must, among other things, think of a thrombosis with following tissue inflammation (congestive dermatitis), a borreliosis after a tick bite, or an allergic reaction.