Why should we have erysipelas especially confined to the face?
Because it is nearest the seat of infection.
Because the secretion of pus produces an abrasion of the mucous membrane or skin and then an inoculation follows.
The inoculation is also made by the handkerchief, but I think more particularly by the finger.
C. W. Major1 reports 4 cases of facial erysipelas in which he says he thinks that the erysipelas was dependent on pathologic conditions of the nose. In 3 there was hypertrophic rhinitis; in 1, a child, chronic congestion. O. J. Stein2 reports a case of suppuration of the antrum of Highmore followed by an attack of erysipelas, and says that many cases of erysipelas are due to unrecognized nasal conditions. Jannson,3 in an extensive article, claims that erysipelas originates from various inflammatory conditions of the nasal mucous membrane. Howard4 reports a small abscess
WELTY CF. ACUTE AND CHRONIC SUPPURATION OF THE EAR AND NOSE THE DIRECT CAUSE OF FACIAL ERYSIPELAS.. JAMA. 1906;XLVII(25):2052-2054. doi:10.1001/jama.1906.25210250006001b