Risk, Prevention, Diagnosis, and Management of Cellulitis and Erysipelas

Purpose of Review: This review summarises the most recent evidence which will inform therapeutic guidance and discusses areas of uncertainty which might benefit from further investigation. Recent Findings: There are variable definitions of cellulitis and erysipelas, and of recovery and cure, which make it difficult to combine results from studies. The etiology of cellulitis is more clearly associated with beta-hemolytic streptococci. The diagnosis can be more accurately made using scoring systems and measurements of skin surface temperature. Antibiotic therapy should be oral in most cases and need not be prolonged despite extensive skin damage. Prevention using antibiotic prophylaxis works but there is no sustained benefit after cessation. Summary: There are areas of uncertainty which would benefit from further research: the roles of adjuvant therapies, the best analgesia, the best way of preventing recurrences whilst limiting antibiotic exposure, the dosing of antibiotics, and what criteria to use in deciding on hospital admission and parenteral therapy.