Factors associated with acute and recurrent erysipelas in a young population: a retrospective of 147 cases

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Amal Chamli
Kahena Jaber
Imene Ben Lagha
Malek Ben Slimane
Faten Rabhi
Nejib Doss
Mohamed Raouf Dhaoui

Abstract

Abstract
Background: erysipelas is a common infection of the superficial layer of the skin, predominantly caused by groups A β-hemolytic streptococci. It is an acute infection of the skin and frequently affects the legs. It is common in the elderly and favoured by the associated comorbidities. Its occurrence in young healthy people is rare.
Aim: The present study aimed to elucidate factors associated with acute and recurrent erysipelas in a young population.
Methods: We retrospectively analyzed 147 cases of erysipelas admitted to the dermatology department of the Military Hospital of Tunis, Tunisia, over 18 years, identifying factors associated with recurrence. All patients were aged less than 35 years.
Results: During the study period, 147 patients were registered with the diagnosis of erysipelas. There were 125 military soldiers and 22 non-military patients. The prevalence of erysipelas was 2.23%. The median age was 25 years. Almost 86.2% of patients were male. The main favorable factors were: obesity (9%), alcoholism (8%), chronic venous insufficiency (6.5%), chronic lymphedema (3%), leg fracture (2%), and diabetes mellitus (1%). The lesions were mostly located in the lower limbs in 94.9%. According to our multivariate analysis, there was an association between recurrence and diabetes mellitus (p=0.02), female sex (p=0.004), onychomycosis (p=0.004), and plantar dyshidrotic eczema (p<0.005).
Conclusion: Identifying factors associated with recurrent erysipelas in a young population remains essential for proposing primary and secondary prevention measures.

Keywords:

erysipelas, recurrence, associated factors

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References

  1. 1. Bonnetblanc J-M, Bedane C. Erysipelas: Recognition and Management. Am J Clin Dermatol 2003;4(3):157‑63. 2. Pereira de Godoy JM, Galacini Massari P, Yoshino Rosinha M, Marinelli Brandão R, Foroni Casas AL. Epidemiological Data and Comorbidities of 428 Patients Hospitalized With Erysipelas. Angiology 2010;61(5):492‑4. 3. Mokni M, Dupuy A, Denguezli M, et al. Risk Factors for Erysipelas of the Leg in Tunisia: A Multicenter Case-Control Study. Dermatology 2006;212(2):108‑12. 4. Brishkoska-Boshkovski V, Kondova-Topuzovska I, Damevska K, Petrov A. Comorbidities as Risk Factors for Acute and Recurrent Erysipelas. Open Access Maced J Med Sci 2019;7(6):937‑42. 5. Dupuy A, Benchikhi H, Roujeau J-C, et al. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ 1999;318(7198):1591‑4. 6. Inghammar M, Rasmussen M, Linder A. Recurrent erysipelas - risk factors and clinical presentation. BMC Infect Dis 2014;14(1):270. 7. Karppelin M, Syrjänen J, Siljander T, et al. Factors predisposing to acute and recurrent bacterial non-necrotizing cellulitis in hospitalized patients: a prospective case-control study. Clin Microbiol Infect 2010;16(6):729‑34. 8. Marrakchi W, Aouam A, Kooli I, et al. Le diabète est-il encore un facteur prédictif de la récidive de l'érysipèle du membre inférieur ? Ann Endocrinol 2016;77(4):517. 9. Pitché P, Diatta B, Faye O, Diané B-F, Sangaré A, Niamba P, et al. Facteurs de risque associés à l'érysipèle de jambe en Afrique subsaharienne : étude multicentrique cas-témoins. Ann Dermatol Vénéréologie 2015;142(11):633‑8. 10. Chlebicki MP, Oh CC. Recurrent Cellulitis: Risk Factors, Etiology, Pathogenesis and Treatment. Curr Infect Dis Rep 2014;16(9):422. 11. Leclerc S, Teixeira A, Mahé E, Descamps V, Crickx B, Chosidow O. Recurrent Erysipelas: 47 Cases. Dermatology 2007;214(1):52‑7. 12. Mahé E, Toussaint P, Lamarque D, Boutchnei S, Guiguen Y. [Erysipelas in the young population of a military hospital]. Ann Dermatol Venereol 1999;126(8‑9):593‑9.