title: Local complications of erysipelas: a study of associated risk factors.
abstract: BACKGROUND
  Local complications of erysipelas include haemorrhagic, bullous, abscessing and necrotic lesions. The risk factors predisposing patients to local complications are not fully known.
  
  
  OBJECTIVE
  To examine local complications of erysipelas and to identify possible risk factors predisposing to their appearance.
  
  
  METHODS
  Medical records from all patients hospitalized with complications of erysipelas (purpura, bullae, abscesses and necrosis), admitted to the University Hospital of Heraklion between 1994 and 2002, were retrospectively studied. Clinical and laboratory data were compared with those from patients with erysipelas without local complications.
  
  
  RESULTS
  In total, 145 patients were analysed, of whom 46 had local disease complications. Using bivariate analysis, the factors significantly associated with disease complications were found to be age ≥ 51 years, obesity, longer duration of local symptoms, and fever on admission. During hospitalization, increased C-reactive protein level, isolation of pathogens, longer duration of fever and/or presence of leucocytosis, absence of response to initial antibiotic therapy, and longer length of hospitalization were also associated with complications in the bivariate analysis. However, in the multivariate analysis, obesity (OR 4.489, 95% CI 1.719-11.725, P = 0.002) was the only independent factor associated with complicated erysipelas.
  
  
  CONCLUSIONS
  This study found obesity to be an independent risk factor for local complications, of erysipelas. Hence, obese patients with erysipelas are prone to complications, and should be carefully evaluated because of the potential severity of disease and the increased risk of failure of empirical antimicrobial therapy.
authors.affiliation: Department of Dermatology, University Hospital of Heraklion, Heraklion, Greece. krasagak@med.uoc.gr
authors.forename: K
authors.initials: K
authors.lastname: Krasagakis
authors.forename: G
authors.initials: G
authors.lastname: Samonis
authors.forename: A
authors.initials: A
authors.lastname: Valachis
authors.forename: P
authors.initials: P
authors.lastname: Maniatakis
authors.forename: G
authors.initials: G
authors.lastname: Evangelou
authors.forename: A
authors.initials: A
authors.lastname: Tosca
mesh_terms: D000038:Abscess / Q000209:etiology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D001768:Blister / Q000209:etiology*; D002097:C-Reactive Protein; D004886:Erysipelas / Q000150:complications*; D005334:Fever / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein