Symptoms and causes

St Anthony's fire or erysipelas is an infection of the skin and the subcutaneous fat layer by skin bacteria (usually streptococcus, but sometimes also staphylococcus). The bacteria enter the body through an opening in the skin, we call this the 'entrance gate', which is like a gap between the toes of a foot fungus, a longer existing wound, untreated eczema. The skin is red, painful and warm to the touch. Often there is also swelling of the skin. Patients who have erysipelas can also have a fever and feel generally unwell. Usually we see these skin infections on the legs, but they can also occur in other places such as the arms and face.

Diagnosis and treatment

The diagnosis is made by the physician based on the visible symptoms. A blood test is often also carried out to see how much inflammation is present in the blood. Sometimes, St Anthony's fire on a leg can also look like a thrombosis leg, therefore an ultrasound of the leg is sometimes requested.

Treatment of erysipelas is with antibiotics in pills form. If the patient is ill, the inflammation is very high in the blood and/or the erysipelas is very extensive, patients are sometimes admitted to the hospital for IV antibiotics because this may act more quickly compared to tablets. It is also important to tackle the 'entrance gate'. If there is a foot fungus, for example, we must treat it in order to prevent further infections. Compression therapy is also important for healing. This means that we are going to bandage the skin in order to promote the drainage of excess moisture and decongestion. Our lymph orbits that normally drain the excess fluid are, as it were, overloaded by the inflammation, so they need help to normalise the swelling. Compression therapy is recommended until a month after healing. This can be done with bandages and then compression stockings.

Treatment centres and specialisations

Dermatology

Latest publication date: 21/01/2021
Supervising author: Dr Van Autryve Els