Background and objective: A complicated course of erysipelas is not uncommon. Bullous, haemorrhagic, necrotic and purulent lesions may be encountered. Today no reliable data exist as to which constitutional factors renders a patient at risk for developing complicated erysipelas though several risk factors, particularly diabetes mellitus, are often suggested. Based on the analysis of patients with erysipelas at the Department of Dermatology in Graz, factors determining the risk for complicated erysipelas should be identified.
Patients/methods: In a retrospective case-control study clinical data sheets of 766 in- patients treated at the department were evaluated with respect to the course of the erysipelas and with respect to potential risk factors.
Results: General risk factors for local complications were location at the lower extremities, pre-existing hepatic or renal disease, hyperuricaemia, and diabetes mellitus. Hepatic and renal disease and - to a lesser extent - diabetes particularly predisposed for bullous and haemorrhagic lesions, while vascular occlusive disease enhanced the risk for necrotic lesions.
Conclusions: Location and hepatic and renal disease are the most important risk factors, while diabetes is probably of less significance than previously suggested.