Bullous erysipelas: what it is, symptoms and treatment

Bullous erysipelas is a more severe type of erysipelas, which is characterized by a red and extensive wound, caused by the penetration of a bacterium calledGroup A beta-hemolytic streptococcus through small cracks in the skin, which can be a mosquito bite or a ringworm on the feet, for example.

In common erysipelas, this wound is more superficial and extensive, and in the case of bullous erysipelas, bubbles may form with transparent or yellowish liquid. The wound is deeper, and in some cases it can cause complications and affect the fatty layer and even the muscles.

Although it can appear in anyone, bullous erysipelas is more common in people with weakened immune systems, with advanced cancer, HIV-positive or decompensated diabetics. In addition to erysipelas, a type of skin infection that can also arise is infectious cellulitis, which usually affects deeper parts of the skin. Check out how to know if it's an erysipelas or infectious cellulitis.

Bullous erysipelas is not contagious, that is, it does not spread from person to person.

Main symptoms

The symptoms of bullous erysipelas are:

  • Sore on the red, swollen, painful skin, approximately 10 cm long, with blisters that present a transparent, yellow or brownish liquid;
  • Emergence of "tongue" in the groin, when the wound affects the legs or feet;
  • Pain, redness, swelling and increased local temperature;
  • In the most severe cases, there may be a fever.

When the infection gets worse, especially when the treatment is not done correctly, it is possible to reach deeper layers of the skin, such as subcutaneous tissue and may even cause destruction of the muscles, as in necrotizing fasciitis.

The diagnosis of bullous erysipelas is confirmed by the evaluation of the general practitioner or dermatologist, who identifies the characteristics of the lesion and the symptoms presented by the person. Tests such as a complete blood count may be ordered to monitor the severity of the infection, and imaging tests such as computed tomography or magnetic resonance imaging may be ordered in the case of injuries that reach very deep layers, muscles or bones.

Learn more about the characteristics and how to identify the erysipelas.

What causes bullous erysipelas

Bullous erysipelas is not contagious, since it occurs when bacteria that already live on the skin and in the environment manage to penetrate the skin through a wound, an insect bite or foot chills, for example. the main causative bacteria is theStreptcoccus pyogenes, although other bacteria can also cause it, less frequently.

People with weakened immunity, such as those with autoimmune diseases, uncontrolled diabetes, HIV, as well as obese people and people with poor circulation, as in these cases bacteria can proliferate more easily.

How the treatment is done

Treatment for bullous erysipelas is done with antibiotics prescribed by the doctor. Generally, the first choice is Benzathine Penicillin. In addition, it is important to reduce swelling by taking complete rest with your legs elevated, and it may be necessary to bandage your leg to reduce swelling more quickly.

The cure for bullous erysipelas can be reached in approximately 20 days after starting antibiotic therapy. In case of recurrent erysipelas, treatment with benzathine Penicillin G is recommended every 21 days, as a way of preventing new illnesses. See more about forms of treatment with antibiotics, ointments and when it is necessary to stay in the hospital.

In addition, during the treatment of erysipelas, it is recommended that the nurse dressings with correct cleaning of the lesion, removal of secretions and dead tissues, in addition to the use of ointments that help in the healing process, such as hydrocolloid, hydrogel, papain or collagenase, depending on the characteristics of each person's injury. Check out how to make a wound dressing.