. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. tension of erysipelas, espe-cially on the face, has been compared to lambentflames. When the disease spreads over the wholebody, it is spoken of as migratory erysipelas. Erysipelas may occur wherever there is a solutionof continuity in the skin—after scratches and excoria-tions, after all injuries and operation wounds. Itmay also be combined with various pyogenic affec-tions—whitlow and phlegmon (especially staphylo-coccal phlegmon). Conditions which give rise to con-stant irritation
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. tension of erysipelas, espe-cially on the face, has been compared to lambentflames. When the disease spreads over the wholebody, it is spoken of as migratory erysipelas. Erysipelas may occur wherever there is a solutionof continuity in the skin—after scratches and excoria-tions, after all injuries and operation wounds. Itmay also be combined with various pyogenic affec-tions—whitlow and phlegmon (especially staphylo-coccal phlegmon). Conditions which give rise to con-stant irritation of the skin, such as lupus, tuberculousfistula, ulcer of the leg, foreign bodies, etc., may alsogive rise to erysipelas, which is then often erysipelas of the face and leg may causeelephantiasis. Lastly, erysipelas may arise in gen-eral streptococcal infection, and is then always com-bined with other pyogenic conditions—abscess, phleg-mon, etc. The common form of erysipelas, which consists ina red elevation of the skin, is called erythematous 204 Bockenheimer, Atlas. Tab. 1 .\.\l. Fiy. QO. Hrvsipelas crvlliematosiiin. Dffhmin Cnw^^.^^,. !/ erysipelas (Fig. 90). In bulbous erysipelas the skinis covered with vesicles (Fig. 91). In hemorrhagicerysipelas there is hemorrhage in the skin (Fig. 91).In the great majority of cases there is resolution, butsometimes erysipelas may cause cutaneous abscesses,and in the form of gangrenous, phlegmonous erysipe-las may give rise to ulceration and extensive destruc-tion of the skin. The clinical sjTnptoms of erysipelas are character-istic. The disease usually commences by a rigor,high temperature (40°-42° C.) and redness of theskin. There is itching and tension in the skin, andtenderness on pressure. There is considerable con-stitutional disturbance owing to high fever, head-ache and vomiting which continue while the diseaseprogresses. The temperature falls suddenly, theredness ceases to extend, and the sk
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