Difference Between Erysipelas and Cellulitis

Key Difference – Erysipelas vs Cellulitis
 

Erysipelas and cellulitis are two fairly common infections of the skin and subcutaneous tissues caused by the entry of pathogenic microbes via the breaches in the superficial epidermal layers. In erysipelas, the lesions are more localized and have clearly demarcated boundaries, unlike in cellulitis, where the lesions are generalized and lack proper well-defined margins. This is the key difference between the two infections.

CONTENTS

1. Overview and Key Difference
2. What is Erysipelas
3. What is Cellulitis
4. Similarities Between Erysipelas and Cellulitis
5. Side by Side Comparison – Erysipelas vs Cellulitis in Tabular Form
6. Summary

What is Erysipelas?

Erysipelas is an infection of the skin and subcutaneous tissues caused by a pathogenic Streptoccocus. These pathogens have virulent factors capable of producing erythrotoxins that make the affected area erythematous and edematous. The associated edema gives a well-demarcated border to the lesion and this is the most important clinical feature which is helpful in differentiating erysipelas from other cutaneous infections. The patient is usually febrile and has tachycardia along with general debility. Streptococci commonly enter into the underlying tissues via the breaches in superficial epidermal structures. The chance of getting erysipelas increases when there is preexisting venous or lymphatic edema.

Figure 01: Facial Erysipelas

Swabs should be taken from the infected regions for culturing and sensitivity tests. After that, the patient should be treated with broad-spectrum antibiotics.

What is Cellulitis?

This is a bacterial infection of the skin and subcutaneous tissues that is more generalized than erysipelas. Similar to erysipelas this is also associated with breaches in the superficial epidermal layers. The affected region is erythematous and edematous but is not well demarcated. The patient is febrile and has malaise and leukocytosis. Erythema along narrow lymphatics is sometimes visible and it is known as lymphangitis.

Figure 02: Cellulitis of Foot with Prominent Edema

Before beginning the treatments swabs should be taken from the infected tissues for cultures and antibiotic sensitivity tests after which the treatment of the patient with intravenous antibiotics begins. Elevation of the infected limbs is also necessary.

What are the Similarities Between Erysipelas and Cellulitis?

• Both conditions are due to the infection of the skin and subcutaneous tissues mainly by Streptococci.
• Swabs are taken from the infected areas in both erysipelas and cellulitis for culture and antibiotic sensitivity tests
• Broad-spectrum antibiotics are a mainstay in the management of both these infections.
• Erythema and edema are the most prominent clinical features of cellulitis and erysipelas.

What is the Difference Between Erysipelas and Cellulitis?

Summary – Erysipelas vs Cellulitis

Both erysipelas and cellulitis are infections of the skin and subcutaneous tissues. The lesions in erysipelas are more localized with well-demarcated boundaries but in cellulitis, the lesions are more widespread and lack proper margins. This is the difference between the Erysipelas and Cellulitis.

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Reference:

1.’Bailey and Love’s Short Practice of Surgery’. Edited by Norman S Williams, Christopher J.K Bulstrode and P.Ronan O’Connell, 26th ed., CRC Press , 2013.

Image Courtesy:

1.’Facial erysipelas’By CDC/Dr. Thomas F. Sellers/Emory University (Public Domain) via Commons Wikimedia 
2.’Cellulitis of foot 02’By cbinrva – Own work, (CC BY-SA 4.0) via Commons Wikimedia

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