Bullous-hemorrhagic facial erysipelas as a complication of poorly controlled diabetes

Abstract

Erysipelas is an acute cutaneous infection with the β-hemolytic Streptococcus group A, causing erythemo-edematous, hemorrhagic, bullous or even necrotic lesions. In this case a 59-year-old woman with type 2 diabetes irregularly treated with oral antidiabetic drugs and with poorly controlled diet, who was admitted to the department because of an acute onset of extensive erythema-edematous and bullous lesions on the face. In most cases erysipelas is present on lower extremities, however, involvement of the face is also not rare. Despite typical presentation, erysipelas of the face may be problematic for general practitioners. In many cases the disease is misdiagnosed with acute contact dermatitis, lupus erythematosus or rosacea. Demonstrating our patient we would like to point out the necessity of the correct diagnosis of erysipelas and proper controlling of concomitant disorders, which may promote streptococcal infections of the skin.