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January 1995

Picture of the Month

Author Affiliations

From the Departments of Pediatrics, Children's Medical Center of Brooklyn (NY), Kings County Hospital Center, University Hospital of Brooklyn (Drs Shah and Santucci), and The Children's Hospital of Philadelphia (Pa) (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1995;149(1):55-56. doi:10.1001/archpedi.1995.02170130057013

ANEONATE (Figure 1) and three older children (Figure 2 through Figure 4) have a rapidly advancing, tender, slightly raised, erythematous rash. All of the children were febrile.

Denouement and Discussion 

Erysipelas  Erysipelas is a superficial form of cellulitis involving the dermis and the uppermost portions of the subcutaneous tissue. The characteristic picture consists of an area of cellulitis with an clevated, rapidly advancing border that is sharply demarcated. This distinguishes it from other forms of cellulitis in which the border is not as distinct. There is an acute onset of a tender, tense, deeply erythematous, indurated plaque that sometimes has a peau d'orange appearance. The intense edema may lead to the formation of tense bullae on the surface of the lesion, which later rupture and crust.The initiating lesion of erysipelas is frequently inconspicuous. The face and extremities are common sites. In the first half of this century, the face

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