Erysipelas

Erysipelas is a superficial form of cellulitis caused predominantly by Group A Streptococcus, also called Streptococcus pyogenes. It develops quickly and produces a hot, painful, bright-red plaque that is raised above the surrounding skin and has a sharply defined edge. Fever and chills often accompany the local findings. The experienced nurse notices the combination rather than any single feature: rapid change, a clean elevated border, and systemic symptoms. A red leg without fever may have several causes; a rapidly expanding, tender plaque with chills should be treated as an acute infection until assessed by the prescriber. The border helps distinguish erysipelas from typical cellulitis. Cellulitis involves deeper tissues and more often has a flatter, poorly defined margin. The distinction is not absolute, and both conditions can threaten tissue or progress systemically. A sharply outlined lesion is not a reason to underestimate the patient’s illness.