Rare recurrent gluteal erysipelas associated with pressure ulcers in elderly patients: A report of two cases

Erysipelas is an acute infection of the upper dermis layer of the skin. Contrary to the usual cellulitis, erythema of erysipelas has a very conspicuous irregular shape with clear demarcation from the surrounding normal skin. Recurrence is frequently observed. Gluteal erysipelas is very rare, reported to be found in only 0.6% of all patients with erysipelas. No previous report was found regarding gluteal erysipelas associated with pressure ulcers. We herein report two elderly cases of recurrent gluteal erysipelas with pressure ulcers. Strikingly, erythema was distributed far from the wounds, and the contours of erythema in the recurrent erysipelas were quite similar to those of the original erysipelas in both cases. Possible involvement of microcirculatory impairment of lymphatic vessels due to previous inflammation was discussed.