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 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
Shah BR, Santucci K, Tunnessen WW. Picture of the Month. Arch Pediatr Adolesc Med. 1995;149(1):55-56. doi:10.1001/archpedi.1995.02170130057013