Erysipelas is an acute superficial spreading infection commonly caused by Streptococci without pus formation.

It could also be due to Gram negative bacilli.

Symptoms and clinical presentation of erysipelas

A prodrome of fever, chills, and malaise

  • Locally, a large erythematous, swelling, well-demarcated, and usually raised lesion
  • Regional adenopathy is frequent
  • Superficial blistering secondary to edema,
  • Superficial hemorrhage, may be sometimes be observed.

Treatment for Erysipelas

Non-pharmacological Treatment

  1. Bed rest
  2. Elevation of the affected part
  3. Venous compression is recommended during the acute phase and subsequent weeks to reduce the risk of lymphedema
  4. Prophylaxis of deep venous thrombosis (DVT) should be considered depending on presence of other risk factors

Pharmacological Treatment

Weak potassium permanganate soaks.

1:40000 (0.025%) solution, 12hourly for 3 to 4 days, with each session lasting for 15 to 20minutes


Silver sulfadiazine cream (topical), 12 to 24 hourly


Mupirocin (topical) 2% 12 hourly for 5 to 7days


Fusidic Acid (topical) 2% 12 hourly for 6 to 7days


Phenoxymethylpenicillin (PO):

  • Adult 250-500mg:
  • Child: 25mg/kg 6hourly for 5 to 7days


Flucloxacillin amoxicillin (FDC) (PO):

  • Adult 500mg:
  • Child: 25 to 50/kg 6hourly 5 to 7 days


Ibuprofen 400mg (PO) 6hourly for 5days

Referral criterion

Refer if there are local or general signs severity of developing necrotizing fasciitis.

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