Erysipelas is a superficial bacterial infection of the skin most often caused by beta-hemolytic group A streptococci (Streptococcus pyogenes). It frequently extends into the cutaneous lymphatics. Erysipelas can occur on the face but is more commonly seen on the lower extremities of patients with venous insufficiency and stasis dermatitis. Trauma to the skin is an important factor in the development of erysipelas; therefore, a concomitant dermatophyte infection, surgical incision, ulceration, insect bite, or inflammatory skin condition may provide a portal of entry for bacteria. Additional predisposing factors for erysipelas include alcohol use disorder, diabetes, immunocompromised states, and nephrotic syndrome.

Erysipelas appears as a strikingly red, well-demarcated plaque that often exhibits pruritus, tenderness, or burning paresthesias. Commonly involved areas are the face, extremities, and penis. Systemic symptoms including fever, chills, malaise, and arthralgia may accompany the condition. Penile erysipelas responds to treatment with antibiotics but tends to recur, causing a progressive chronic lymphedema with permanent swelling of the penis (elephantiasis). Elephantiasis may also develop in the lower extremities from recurring bouts of erysipelas.