Erysipeloid: A Rare Entity of Acute Non-Necrotizing Bacterial Dermohypodermitis, Case Report

Erysipeloid is a professional cutaneous infection caused by the traumatic penetration of Erysipelothrix rhusiopathiae. Clinically, the disease is characterized by erythematous edema with well-defined, raised edges, usually localized on the back of a hand and/or fingers. Vesicular, bullous, and erosive lesions may also be present. The lesion can be asymptomatic or associated with mild itching, pain, and fever. It was a 38-year-old female fishmonger from Benin, with a history of penicillin allergy manifesting as urticaria, who consulted the Buruli Ulcer Screening and Treatment Center in Allada for tissue loss evolving over the past 7 days, following a microtrauma from the fin of a tilapia fish. She initially treated it with ice. The onset of pain 24 hours later, along with swelling of the right hand, led the patient to self- medicate with ibuprofen and topical phytotherapy, resulting in transient improvement. On examination, an oval-shaped ulcer measuring approximately 2 cm in diameter and 0.5 cm in depth was noted, with an erythematous, oozing base, secreting a cloudy liquid with crusty edges and well-defined borders. The perilesional skin was infiltrated in some areas with a firm consistency. There was the presence of an inflammatory axillary lymphadenopathy measuring 6x4 cm in diameter. The diagnosis of erysipeloid of the right hand was established. The patient received treatment consisting of ciprofloxacin, metronidazole, an analgesic, and daily dressings. The progression under this treatment was favorable, with significant improvement after 15 days. Erysipeloid is an infection whose onset may seem trivial or even harmless to the patient. However, the complications are often fatal. This highlights the importance of prevention, such as wearing household gloves for those exposed to high-risk occupations.

Keywords: Erysipeloid, Dermohypodermitis, Case.