ERYSIPELAS is an acute inflammation of the superficial soft tissues most frequently caused by Streptococcus pyogenes. It presents with erythematous swelling, a burning sensation, and well-defined margins (stepladder sign), which can affect the face or limbs and is often associated with high fever (up to 41°C axillary temperature).

Its systemic manifestations vary widely, rarely involving deep soft tissues and readily regressing if treated with penicillins. After about 5-10 days from the acute episode, there may be massive peeling of the affected skin. Patients with lymphedema have an increased risk of developing this type of infection. In these individuals, lymphatic manifestations, although not solely related to Streptococcus pyogenes infections, present mixed clinical pictures and are called “erysipeloid lymphangitis.” In the figure: Examples of erysipeloid lymphangitis. 

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