Becq-Giraudon B
Service de Médecine Interne, Maladies Infectieuses et Tropicales, CHU de Poitiers, France.
Ann Dermatol Venereol. 2001 Mar;128(3 Pt 2):368-75.
Erysipelas is a bacterial infection of the deepest skin layer. Predisposing factors are systemic and/or local. Main systemic factors are alcoholism, diabetes and immunodeficiency. The main local factors are an Athlete's foot (tineapedis), venous or lymphatic stasis, prosthetic surgery of the knee, and a past history of saphenous phlebectomy, lymphadenectomy, or irradiation. Such predisposing factors account for the predominance of erysipelas in the lower limbs and for the frequency of recurrence. The prevention of recurrence is stressed by all authors, and would associate correct treatment of the disease, treatment of venous and lymphatic stasis and/or wounds. A preventive antibiotic treatment should be proposed to patients with multiple predisposing factors and frequent recurrence, by using prolonged therapy with Macrolides or Penicillin. Primary prevention could concern local and/or systemic predisposing factors; however its efficacy and necessity has yet to be demonstrated. The usefulness of nosopharyngeal streptococcal carriage eradication and/or vaccination has not demonstrated either.
丹毒是最深层皮肤的细菌感染。诱发因素包括全身性和/或局部性因素。主要的全身性因素是酗酒、糖尿病和免疫缺陷。主要的局部因素是足癣（脚癣）、静脉或淋巴淤滞、膝关节假体手术以及大隐静脉切除术、淋巴结切除术或放疗的既往史。这些诱发因素导致丹毒在下肢的 predominance 以及复发频率。所有作者都强调预防复发，这将涉及疾病的正确治疗、静脉和淋巴淤滞及/或伤口的治疗。对于有多种诱发因素且频繁复发的患者，应通过使用大环内酯类或青霉素进行长期治疗来建议预防性抗生素治疗。一级预防可能涉及局部和/或全身性诱发因素；然而，其有效性和必要性尚未得到证实。消除鼻咽部链球菌携带和/或接种疫苗的有用性也尚未得到证实。 （注：原文中“predominance”未翻译完整，可能是输入有误，正常应翻译为“优势、 predominance”）
