What is the Difference Between Erysipeloid and Erysipelas

The main function of the skin is to act as a barrier against the external environment. Skin conditions, also known as cutaneous conditions, refer to medical conditions that typically affect the skin, nails, and related muscles and glands. Erysipeloid and erysipelas are two skin conditions caused by bacteria.

The key difference between erysipeloid and erysipelas lies in their causative agents. Erysipeloid is a painful, inflammatory skin lesion caused by Erysipelothrix rhusiopathiae, whereas erysipelas is a superficial form of cellulitis caused by Streptococcus or Staphylococcus bacteria.

CONTENTS

1. Overview and Key Difference
2. What is Erysipeloid 
3. What is Erysipelas
4. Similarities – Erysipeloid and Erysipelas
5. Erysipeloid vs Erysipelas in Tabular Form
6. Summary – Erysipeloid vs Erysipelas
7. FAQ: Erysipeloid and Erysipelas

What is Erysipeloid?

Erysipeloid is an acute bacterial infection of the skin and other organs. It is caused by the microorganism Erysipelothrix rhusiopathiae. People at higher risk of developing erysipeloid include fishermen, farmers, butchers, abattoir workers, veterinary surgeons, and cooks. The signs and symptoms of erysipeloid may include clearly defined bright red to purple lesions with smooth, shiny surfaces on the skin of hands, fingers, or forearms, lesions that expand over a few days with sharp or curvaceous borders which may have tiny blisters, warmness, and tenderness on the lesions that cause pain or burning sensations, mild fever, chills, and malaise.

Figure 01: Erysipeloid

Erysipeloid is diagnosed through culture, biopsy of the specimen, and PCR. Furthermore, erysipeloid can be treated with antibiotics such as penicillin and cephalosporin. Patients allergic to penicillin may be treated with a combination of erythromycin and rifampicin, a tetracycline , or ciprofloxacin.

What is Erysipelas?

Erysipelas is a form of cellulitis. Erysipelas usually only affect the upper layers of the skin. The signs and symptoms of erysipelas may include swollen and shiny, redness skin area, warmness and tenderness on the affected area, blisters, sharp edges between the affected and unaffected skin, red streaks above the affected area, and the affected area turning purple or black in severe cases, fevers, chills, shivering, and high temperature. Moreover, erysipelas is caused by Group A beta-haemolytic Streptococci (Streptococcus pyogenes) and Staphylococcus.

Figure 02: Erysipelas

Erysipelas is diagnosed through physical examination, medical history, blood test, CRT scan, and MRI. Furthermore, treatment options for erysipelas may include antibiotics such as penicillin, erythromycin or cephalexin.

Similarities Between Erysipeloid and Erysipelas

• Erysipeloid and Erysipelas are both skin infections.
• Both are caused by bacteria.
• Both can be diagnosed through physical symptom evaluations.
• They can be treated by giving specific antibiotics like penicillin , cephalosporin, and rifampicin.

Difference Between Erysipeloid and Erysipelas

Definition

1. Erysipeloid is an acute dermatitis that is caused by E. rhusiopathiae.
2. Erysipelas is a form of cellulitis that is caused by Streptococci or Staphylococci.

People at Risk

1. People at risk of erysipeloid include fishermen, farmers, butchers, abattoir workers, veterinary surgeons and cooks.
2. People at risk of erysipelas include people who have obesity, lymphedema, athlete’s foot, leg ulcers, eczema, intravenous drug use, poorly controlled diabetes, and liver disease.

Signs and Symptoms

1. The signs and symptoms of erysipeloid may include bright red to purple lesions with smooth, shiny surfaces, typically appearing on the hands, fingers, or forearms. These lesions gradually expand over a few days, developing sharp or curving borders, sometimes with tiny blisters. Additional symptoms may include warmth and tenderness in the affected area, pain or a burning sensation, mild fever, chills, and malaise.
2. The signs and symptoms of erysipelas may include swollen, shiny, and reddened areas of skin, often accompanied by warmth and tenderness. Blisters may form, and there is typically a distinct border between affected and unaffected skin. Red streaks may extend above the affected area, and in severe cases, the skin may turn purple or black. Systemic symptoms such as fever, chills, shivering, and a high temperature may also occur.

Diagnosis

1. Erysipeloid is diagnosed by culture, biopsy of the specimen, and PCR.
2. Erysipelas is diagnosed by physical examination, medical history, blood test, CRT scan, and MRI.

The following table summarizes the difference between erysipeloid and erysipelas.

Summary – Erysipeloid vs Erysipelas

Skin infections affect the integumentary system of the body. Both erysipeloid and erysipelas are two skin infections caused by bacteria. However, erysipeloid refers to cutaneous infection by Erysipelothrix rhusiopathiae while erysipelas refers to a superficial cellulitis caused by Streptococci or Staphylococci. This is the basic difference between erysipeloid and erysipelas.

FAQ: Erysipeloid and Erysipelas

1. What causes erysipeloid?

• Erysipeloid is an occupational skin infection that is caused by traumatic penetration of a bacteria called Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous edema with well-defined and raised borders. The lesions are usually localized to the back of one hand and/or fingers.

2. What is the treatment for erysipeloid?

• Erysipeloid is usually treated with a 7-day course of antibiotics, including penicillin V or ampicillin (500 mg orally every 6 hours), ciprofloxacin (250 mg orally every 12 hours), and clindamycin (300 mg orally every 8 hours).

3. What is erysipelas caused by?

• Erysipelas is caused by Group A Streptococcus bacteria and can affect both children and adults. The condition often develops when bacteria enter the skin through a break, such as a cut or wound.

4. What is the most common site of erysipelas?

• Approximately 80% of erysipela cases occur on the legs rather than the face. However, the change in distribution from the face to the lower extremities is most likely observed in the aging population with risk factors such as lymphedema.

5. What is the best treatment for erysipelas?

• Erysipelas is normally treated by penicillin administered orally or intramuscularly for 5 days. But if there is no improvement in the infection, treatment duration should be extended. Moreover, if person is allergic to penicillin a first-generation cephalosporin may be used.

Reference:

1. “Erysipelas – Dermatologic Disorders.” MSD Manual Professional Edition.
2. “Erysipeloid.” MedlinePlus, Medical Encyclopedia. U.S. National Library of Medicine.

Image Courtesy:

1. “Erysipeloid skin rashes in Familial Mediterranean Fever” By Dr. H.J. Lachman – Online Library Wiley (CC BY 4.0) via Commons Wikimedia
2. “Erysipelas in a foot” By Tommi Nummelin – Own work (CC BY-SA 3.0) via Commons Wikimedia

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