Caetano Mónica, Amorin Isabel
Serviço de Dermatovenereologia, Hospital Geral de Santo António, S.A., Porto.
Acta Med Port. 2005 Sep-Oct;18(5):385-93. Epub 2005 Oct 16.
Erysipelas is an acute dermo-hypodermal infection (non necrotizing) of bacterial origin, mainly group A beta-haemolytic streptococcus. The lower limbs are affected in more than 80% of the cases and the identified risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and based upon the association of an acute inflammatory plaque with fever, lymphangitis, adenopathy and leukocytosis. Bacteriology is usually not helpful because of low sensitivity or delayed positivity. In the atypical forms erysipelas must be distinguished from necrotizing fasciitis and acute vein thrombosis. Penicillin remains the gold standard treatment, although new drugs, given their pharmacodynamic profile, may be used. Recurrence is the main complication, being crucial the correct treatment of the risk factors.
丹毒是一种源于细菌的急性真皮-皮下感染（非坏死性），主要由A组β溶血性链球菌引起。超过80%的病例累及下肢，已确定的危险因素包括皮肤屏障破坏、淋巴水肿和肥胖。诊断基于临床，依据急性炎症性斑块伴发热、淋巴管炎、淋巴结病和白细胞增多。由于敏感性低或阳性出现延迟，细菌学检查通常无助于诊断。在非典型病例中，丹毒必须与坏死性筋膜炎和急性静脉血栓形成相鉴别。青霉素仍然是金标准治疗药物，尽管鉴于新药的药效学特性也可使用。复发是主要并发症，正确治疗危险因素至关重要。
