As for my patients, erysipelas is a real problem. Every time it arises it destroys the already damaged lymphatic system significantly affecting the limb and patients’ well-being.
The more there is a difference in limb size the more likely erysipelas would occur. A lot of patients with lymphedema complain that they have to deal with erysipelas almost every month.
Causes
Erysipelas is caused by streptococcus. It might be of different grade of invasiveness but the bacteria itself is quite aggressive. We face it day after day, but our immune system is good enough to fight it. When there’s damage in the lymphatic system, that causes difficulties in draining the bacteria out of the body, it starts to flourish in the tissues. That therefore is called erysipelas.
Symptoms
– The limb suddenly becomes reddish
– Fever (38-39 C)
– Swelling progression
– Pain, itching or burning
– The rash may occur, sometimes with vesicles.
If one of those symptoms was seen one should immediately consult a specialist and start antibiotics of penicillin group.
Attention! Erysipelas often require hospital admission, especially if it goes along with intoxication – with fatigue, vomiting, and fever. Fever (39 C) and higher.
The next fact is that erysipelas is contagious.
Unfortunately, if you have erysipelas your lymph vessels are damaged by germs and consequences of immune resistance.
Prophylaxis
– Use moistening cremes.
– Void dryness, wounds or cracks of the skin.
– Avoid excessive manicure, cease using affected arm to take blood tests or measure blood pressure.
– Don’t use compression bandages yourself, this more likely will make it worse.
– Use protective gloves when doing housework.
– Immediately sanitize and put the protective strip on a wounded area.
– Always use special medication for nail fungus.
And finally, in those patients with lymphedema erysipelas might reduce completely after removal of swelled subcutaneous fat tissue. With liposuction infected and swelled tissues are eliminated so that the inflammation site is now absent and tissues’ drainage is improved.
Myths about surgical treatment of erysipelas
Surgery would not help!
No, it would! Thirty years of worldwide experience showed that with carefully done diagnostics and patient screening, every surgical approach might be highly effective for erysipelas treatment.
It is clear that there are no 100% guarantees for every patient due to anatomical differences, varying body weight, age, severity, and frequency of erysipelas episodes.
But what we are sure about is that the effect is visible in every patient but to different degrees.
Lymph node transplantation might cause metastases.
This is the most reasonless fear: lymph nodes are taken from another area where breast cancer metastases cannot appear.
The principal function of lymph nodes is to filter the lymph, as well as the one in metastases. That’s why nodes from the armpit are also removed during breast cancer removal.
Let’s look at it from another point. Imagine a patient having a recurrence of breast cancer after the main site was removed and “preventive” regional lymph node excision was performed. She does not have any protective boundaries, so transplantation of lymph nodes provides her with one along with lymphedema management.