Clinical aspects

Clinically, the lesion is revealed by pain, both spontaneous and when pressure is applied. Locally, an indurated dark red central zone can be observed, surrounded by erythema,. The cellulitis spreads and is typically made up of 3 zones: (1) the peripheral erythematous zone; (2) a dark red and painful intermediate zone; (3) and a gangrenous and necrotic central zone which develops into a large ulcer where granulation and epidermal glands sometimes appear. A very specific fact is that the deep fascia around the muscles is unaffected. Hyperaesthesia of the intermediate zone is also a good sign4. The infection spreads slowly but continuously over a few days or weeks. Satellite lesions can occur due to sub-cutaneous propagation. General signs of infection are subtle and complications rare.

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