Erysipelas

   A 44-year-old man with Crohn’s disease receiving infliximab therapy presented with a two-day history of facial rash. His daughter had recently experienced pharyngitis and his mother had a similar facial rash. Examination showed well-demarcated, erythematous plaques with a dimpled (“peau d’orange”) texture over the cheeks, nose, and glabella. The absence of lymphadenopathy and normal pharynx suggested a localized dermal infection. Blood cultures were obtained due to the patient’s immunosuppressed state and revealed Streptococcus pyogenes. Initially treated with oral cephalexin, he was hospitalized and switched to a 14-day intravenous penicillin G potassium regimen, resulting in complete resolution after five days.

   A 44-year-old man with Crohn’s disease receiving infliximab therapy presented with a two-day history of facial rash. His daughter had recently experienced pharyngitis and his mother had a similar facial rash. Examination showed well-demarcated, erythematous plaques with a dimpled (“peau d’orange”) texture over the cheeks, nose, and glabella. The absence of lymphadenopathy and normal pharynx suggested a localized dermal infection. Blood cultures were obtained due to the patient’s immunosuppressed state and revealed Streptococcus pyogenes. Initially treated with oral cephalexin, he was hospitalized and switched to a 14-day intravenous penicillin G potassium regimen, resulting in complete resolution after five days.