[Haemorrhagic cellulitis: three cases].
BACKGROUND
Haemorrhagic erysipelas (cellulitis) is a recently described clinical condition. We report 3 new cases of this rare bacterial dermatosis requiring both antibiotics and systemic corticosteroids for complete resolution.


METHODS
Case 1 was a 75 year-old male patient, with a past history of hypertension and diabetes mellitus. Case 2 was a 69 year-old female patient with a past history of hepatic cirrhosis. Case 3 was a 56 year-old female patient without medical past history, except for obesity. All patients presented with a haemorrhagic and bullous erysipelas of the leg without clinical improvement under parenteral antibiotics. In all cases, adjuvant systemic corticosteroids (prednisone: 0.5 mg/kg/d) for 5-8 days in addition to antibiotics provided dramatic and complete resolution of skin lesions and disappearance of pain and fever.


CONCLUSIONS
Haemorrhagic cellulitis may be misdiagnosed as necrotizing fasciitis because of ecchymotic areas with frequent bullae resulting in haemorrhagic crusts and partial inefficacy of antibiotics given alone. Adjuvant anticoagulant therapy or coagulation abnormalities may have facilitated the clinical condition in 2 of our 3 cases. The efficacy of adjuvant systemic corticosteroids during 5-8 days, in addition to antibiotics is the hallmark of this syndrome.
Estines
O
O
Service de Dermatologie, CHU Robert Debré, avenue du Général Koenig, 51092 Reims Cedex.
Coste
N
N
Perceau
G
G
Becker
S
S
Leberruyer
P-Y
PY
Bernard
P
P
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D003937:Diagnosis, Differential; D019115:Fasciitis, Necrotizing / Q000175:diagnosis; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents