Erysipeloid

Lore & Background

Erysipeloid, also known as Erysipeloid of Rosenbach, is a cutaneous condition most frequently characterized by a purplish marginated swelling on the hands. The eponym Rosenbach's disease refers to the milder type of the condition and is named after Friedrich Julius Rosenbach. Early work on the condition in US fishermen was carried out by Klauder and colleagues.

Reader's Guide

Erysipeloid is significant as a distinct occupational infection primarily affecting individuals who handle fish, raw meat, or swine. Its importance lies in its frequent misidentification at presentation, which can delay appropriate treatment. The condition is caused by Erysipelothrix rhusiopathiae, which also causes Swine Erysipelas in domestic pigs. Diagnosis relies on the characteristic violaceous swelling with severe pain but without pus, differentiating it from pus-forming streptococcal and staphylococcal erysipelas. Treatment is straightforward with penicillin-based regimens, though erythromycin or doxycycline are alternatives for penicillin-allergic patients. Notably, E. rhusiopathiae is intrinsically resistant to vancomycin, making correct identification critical. While bacteremia and endocarditis are uncommon, they are serious sequelae. The legacy of erysipeloid includes its recognition as a classic zoonotic infection and the historical work of Rosenbach and Klaunders in describing the condition.

Did You Know?

• Erysipeloid is most commonly seen on the hands.
• The infection typically enters through abrasions in the hand.
• Bacteremia and endocarditis are uncommon but serious sequelae of this infection.