Risk factors for erysipelas of the leg in Tunisia: a multicenter case-control study.
BACKGROUND
Risk factors for erysipelas (cellulitis) were rarely evaluated in controlled studies. Regional variations of these risk factors have never be assessed.


OBJECTIVE
To assess risk factors for erysipelas of the leg in Tunisia.


METHODS
Case-control study in seven hospital centers in Tunisia. Cases were 114 consecutive patients with erysipelas of the leg [sudden onset (<24 h) of a well-demarcated dermo-hypodermatitis with fever or chills]. Two controls were matched to each case for age, sex, and hospital (n = 208). Main outcome measures are local and general suspected risk factors for erysipelas of the leg.


RESULTS
In multivariate analysis, disruption of the cutaneous barrier (i.e. traumatic wound, toe-web intertrigo, excoriated leg dermatosis or plantar squamous lesions) and leg edema were independently associated with erysipelas of the leg, with respective odds ratios of 13.6 (95% confidence interval: 6.0-31) and 7.0 (1.3-38). No association was observed with diabetes, alcoholism, or smoking.


CONCLUSIONS
We confirmed the major role of local risk factors and the minor role of general risk factors for erysipelas of the leg, in a setting different than the one previously studied. Detecting and treating toe-web intertrigo and traumatic wounds should be considered in the prevention of erysipelas of the leg.
Department of Dermatology, La Rabta Hospital, Tunis, Tunisia.
Mourad
M
Mokni
Alain
A
Dupuy
Mohamed
M
Denguezli
Raouf
R
Dhaoui
Samir
S
Bouassida
Montacer
M
Amri
Sami
S
Fenniche
Faten
F
Zeglaoui
Nejib
N
Doss
Rafiaa
R
Nouira
Amel
A
Ben Osman-Dhahri
Jamel
J
Zili
Insaf
I
Mokhtar
Mohamed Ridha
MR
Kamoun
Abdelmajid
A
Zahaf
Olivier
O
Chosidow
D016022:Case-Control Studies; D004886:Erysipelas / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007868:Leg Dermatoses / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D014416:Tunisia / Q000453:epidemiology