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Those with diabetes, however, often have worse outcomes. [10] Cellulitis occurred in about 21.2 million people in 2015. [7] In the United States about 2 of every 1,000 people per year have a case affecting the lower leg. [1] Cellulitis in 2015 resulted in about 16,900 deaths worldwide. [8]
This is a shortened version of the twelfth chapter of the ICD-9: Diseases of the Skin and Subcutaneous Tissue. It covers ICD codes 680 to 709 . The full chapter can be found on pages 379 to 393 of Volume 1, which contains all (sub)categories of the ICD-9.
Erysipelas, a bacterial infection which primarily affects superficial dermis, and often involves superficial lymphatics. [10] Unlike cellulitis, it does not affect deeper layers of the skin. It is primarily caused by the Group A beta-hemolytic streptococci, with Streptococcus pyogenes being the most common pathogen. [10]
Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Infection may vary in the depth of tissue to which it extends. Foot infections range from the most superficial, cellulitis, to deeper soft tissue necrotizing fasciitis, which may necessitate limb amputations or become life-threatening. [9] [10] [11] Infections may also extend to bone, termed osteomyelitis.
Erysipelas (/ ˌ ɛ r ə ˈ s ɪ p ə l ə s /) is a relatively common bacterial infection of the superficial layer of the skin (upper dermis), extending to the superficial lymphatic vessels within the skin, characterized by a raised, well-defined, tender, bright red rash, typically on the face or legs, but which can occur anywhere on the skin.
Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.
The management of lipodermatosclerosis may include treating venous insufficiency with leg elevation and elastic compression stockings. [9] In some difficult cases, the condition may be improved with the additional use of the fibrinolytic agent, stanozol. Fibrinolytic agents use an enzymatic action to help dissolve blood clots.