- Acute bacterial infection of the dermis and upper subcutaneous tissue.
- Usually caused by group-A beta-haemolytic streptococcus.
- Patient is ill with high fever and rigors.
- Tender, erythematous, oedematous, well-demarcated area of skin that may blister.
- Usually unilateral and occurs most commonly on the leg and face.
- Urgent treatment is required - phenoxymethylpenicillin or erythromycin, 500mg six-hourly, for 10-14 days.
- Long-term prophylactic antibiotics may be required for those with recurrent attacks.
JESSNER LYMPHOCYTIC INFILTRATE
- Benign chronic T-cell infiltrative disorder.
- Red/brown papules 2-20mm in diameter that enlarge to form well-demarcated red plaques.
- Usually symptomless but may burn or itch.
- Single or multiple.
- Frequently on the face but may occur on the trunk.
- Spontaneous resolution may occur.
- Cosmetic camouflage, topical or intralesional corticosteroids and hydroxychloroquine are sometimes helpful.
- Contributed by Dr Jean Watkins, a GP in Ringwood, Hampshire.