A streptococcal infection (see STREPTOCOCCUS) of the skin characterised by an acute onset with fever, malaise and a striking, usually unilateral, rash (see ERUPTION) almost always on a lower leg or the face. Shivering, local pain and tenderness are associated with a sharply defined, spreading, bright red swollen zone of skin inflammation. On the leg, blistering and PURPURA may follow. The bacteria enter the skin through a fissure in a toe cleft (often associated with tinea pedis – see under RINGWORM) or via a crack in the skin behind an ear or in a nostril.
PENICILLIN by mouth. In those allergic to penicillin, ERYTHROMYCIN can be substituted. Recurrent attacks are common and may cause progressive lymphatic damage leading to chronic OEDEMA. Such recurrences can be prevented by long-term prophylactic oral penicillin.