Gunawan Hendra, Atiyah Dini, Maharani Retno Hesty, Faldian Yogi, Arrum Ravika Khaila
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Clin Cosmet Investig Dermatol. 2025 Mar 25;18:729-733. doi: 10.2147/CCID.S500048. eCollection 2025.
Pseudocellulitis is a non-necrotizing inflammation of the dermis and hypodermis with a non-infectious etiology. One of the variants of pseudocellulitis is acute inflammatory edema (AIE), characterized by bilateral, erythematous, and edematous plaques, often found in critically ill patients. AIE is a rarely reported and frequently overlooked case of pseudocellulitis. Therefore, it needs to be differentiated from classic cellulitis, which has different management and prognosis. This case report aimed to present a case of AIE in a critically ill patient. A 71-year-old woman was admitted to intensive care with reddish swelling on four extremities. She was suffering from sepsis caused by pneumonia, congestive heart failure, tubulointerstitial disease, and hypoalbuminemia. A physical examination showed bilateral erythematous and edematous plaques that palpably felt warm. ALT-70 score was 4, indicating not likely true cellulitis. The patient was diagnosed with AIE and treated with a compression bandage, diuretics, and medications for underlying diseases. The lesions improved significantly on the second day of evaluation; unfortunately, respiratory failure caused the patient's death. Critically ill patients may have AIE misdiagnosed as cellulitis. Therefore, clinicians need to be well-versed in pseudocellulitis, especially AIE, to improve patient outcomes.
假蜂窝织炎是一种真皮和皮下组织的非坏死性炎症，病因是非感染性的。假蜂窝织炎的一种变体是急性炎症性水肿（AIE），其特征为双侧、红斑性和水肿性斑块，常见于危重病患者。AIE是一种报道较少且常被忽视的假蜂窝织炎病例。因此，它需要与经典蜂窝织炎相鉴别，因为两者的治疗和预后不同。本病例报告旨在介绍一例危重病患者的AIE病例。一名71岁女性因四肢出现红肿而入住重症监护病房。她患有由肺炎、充血性心力衰竭、肾小管间质性疾病和低白蛋白血症引起的败血症。体格检查显示双侧红斑性和水肿性斑块，触之有温热感。ALT-70评分为4分，提示不太可能是真正的蜂窝织炎。该患者被诊断为AIE，并接受了加压绷带、利尿剂及针对基础疾病的药物治疗。在评估的第二天，病变明显改善；不幸的是，呼吸衰竭导致患者死亡。危重病患者可能会将AIE误诊为蜂窝织炎。因此，临床医生需要精通假蜂窝织炎，尤其是AIE，以改善患者的治疗效果。
