ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ
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ERYSIPELAS AND ITS COMPLICATIONS: A CLINICAL-ANALYTICAL
STUDY
1
Masharipov S.M.,
2
Masharipova Sh.S.
1
Alfraganus Universiteti,
Toshkent, O
‘
zbekiston
2
Toshkent Tibbiyot Akademiyasi
Urganch filiali, Urganch, O
‘
zbekiston
Annotation:
Erysipelas is an acute infectious disease caused by β-hemolytic
Streptococcus group A, characterized by skin inflammation and febrile syndrome.
Erysipelas remains a pressing issue in infectious dermatology and general medicine.
The incidence of this pathology remains stable, especially among elderly individuals,
in whom the course of the disease is often complicated by concomitant pathologies and
reduced immune reactivity. An important task is timely diagnosis and prevention of
complications such as lymphostasis, recurrences, abscesses, and phlegmon. Based on
clinical and laboratory data, the severity of the disease, the frequency of complications,
and their risk factors were assessed.
Key words:
erysipelas, streptococcus, skin infection, lymphostasis,
complications, elderly patients.
Introduction
Erysipelas, or "erysipelas" in common parlance, is an infectious-allergic disease
characterized by a distinct, localized inflammation of a specific area of the skin and
subcutaneous tissue, as well as pronounced intoxication and fever. The affected area
not only shows significant swelling but also turns a bright red color. Currently,
erysipelas is considered one of the most common bacterial diseases. Erysipelas
predominantly affects people over 50, with women being diagnosed more frequently
than men; however, erysipelas can also appear at a younger age. Factors increasing the
likelihood of developing erysipelas include frequent stress, weakened immunity, and
ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ
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chronic diseases. In its initial stage, erysipelas is usually localized in one specific part
of the div. This could be the face, neck, or perineum. First, the skin reddens, then
swelling begins to develop.
Currently, erysipelas retains high medico-social significance due to frequent
patient incapacitation and a tendency towards recurrent course. The disease is
particularly relevant in the age group over 50, when a decrease in immune protection
and the presence of concomitant pathologies (diabetes mellitus, varicose veins, chronic
venous insufficiency) are observed. Furthermore, despite the availability of
antibacterial therapy, complications of erysipelas, such as lymphostasis, abscesses, and
phlegmon, remain common and require a more active clinical and preventive approach.
The aim of the study
was to analyze the clinical course of erysipelas and its
complications in elderly patients.
Materials and methods
The study analyzed the cases of 12 patients with erysipelas who were treated in
an infectious diseases hospital. The age of the patients ranged from 50 to 70 years,
including 7 women and 5 men. The diagnosis was established on the basis of clinical
data (skin hyperemia, edema, severe soreness, fever) and laboratory tests (leukocytosis,
accelerated ESR). The detection of complications was carried out during observation
and instrumental diagnostics (ultrasound of soft tissues, blood biochemistry).
Results and discussion
In all patients, the disease was characterized by an acute onset, accompanied by fever,
chills and the appearance of a bright red painful area of skin with clear boundaries,
mainly on the lower extremities.
Distribution of complications among patients:
• Lymphostasis — 6 cases (50%)
• Recurrent course — 3 cases (25%)
• Abscesses and infiltrates — 2 cases (16,6%)
• Phlegmon — 1 case (8,4%)
Factors contributing to the development of complications:
ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ
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• Type 2 diabetes mellitus (in 4 cases)
• Varicose veins of the lower extremities (in 5 cases)
• Chronic venous insufficiency
• Non-observance of bed rest and refusal of antibiotic therapy in the past
It was found that patients with concomitant chronic diseases were more likely to
experience severe erysipelas and a tendency to relapse. The most common
complication was lymphostasis, which often leads to tissue fibrosis and disability.
Table 1. Clinical characteristics and complications in patients with erysipelas
(n=12)
№ Age
Gender
Localization
of
inflammation
Concomitant
diseases
Complications
History
of
relapses
1
68
F
Lower limb
Type 2 diabetes
mellitus
Lymphostasis
Yes
2
59
М
Lower limb
Varicose veins
Abscess
No
3
62
F
Face
Arterial
hypertension
No
No
4
54
М
Lower limb
Varicose veins,
obesity
Lymphostasis
Yes
5
70
F
Arm
Chronic venous
insufficiency
Phlegmon
No
6
65
F
Lower limb
Diabetes
mellitus,
obesity
Lymphostasis
Yes
7
58
М
Lower limb
Varicose veins
Lymphostasis
No
8
60
F
Lower limb
Arterial
hypertension
No
No
9
67
М
Face
No
Abscess
No
ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ
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10
61
F
Lower limb
Diabetes
mellitus
Lymphostasis
Yes
11
52
М
Lower limb
Varicose veins
No
No
12
56
F
Lower limb
Fatness
Lymphostasis
No
The data obtained confirm that erysipelas in elderly patients is more severe and
more often complicated. The main risk factor is the presence of chronic diseases that
disrupt microcirculation and the immune response. In particular, patients with diabetes
mellitus have marked lymphostasis, delayed recovery, and a high risk of relapse.
Lymphostasis in half of the patients may be caused by both the destruction of lymphatic
vessels due to inflammation and varicose veins.
Cases of recurrent erysipelas, which develop against the background of non—
compliance with preventive measures such as compression therapy, skin care and
timely treatment of fungal foot infections, are of particular clinical concern. In addition,
repeated episodes of erysipelas aggravate the course of the disease and contribute to
the formation of chronic lymphedema.
Effective therapy requires early administration of penicillin series or
cephalosporins, if necessary, in combination with anti—inflammatory drugs and local
therapy. It is also important to monitor the treatment of the underlying background —
diabetes, cardiovascular pathology, and obesity.
Conclusion
A clinical and analytical study has shown that erysipelas in elderly patients is
characterized by a high risk of complications, the most common of which are
lymphostasis and recurrent course. There is a clear relationship between the presence
of background chronic diseases (diabetes mellitus, varicose veins) and the severity of
erysipelas. The lower extremities are the most common location of inflammation.
The results emphasize the need for an integrated approach in the diagnosis,
treatment and prevention of erysipelas, especially in people over 50 years of age.
Effective therapy and control of concomitant pathologies can reduce the incidence of
ОБРАЗОВАНИЕ НАУКА И ИННОВАЦИОННЫЕ ИДЕИ В МИРЕ
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complications and improve the prognosis of the disease. Awareness-raising among
patients also plays a key role in increasing treatment adherence.
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