[Primary and secondary prevention for erysipelas].

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.