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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Erysipelas and cellulitis are relatively common cutaneous infections that can sometimes be the cause of a prolonged hospital admission&#46; The objective of this study was to determine the most relevant epidemiologic factors and their influence on the length of hospital stay&#44; comparing our results with those of previous studies&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective&#44; observational&#44; cross-sectional study of 122 patients admitted over a 5-year period to the dermatology department of our hospital with a diagnosis of erysipelas or cell&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Patients with a diagnosis of erysipelas or cellulitis represented 8&#46;6&#37; of all admissions during the study period&#46; The mean age was 58&#46;93 years and the female to male ratio was 1&#46;06&#58;1&#46; The most common site of involvement was on the legs &#40;76&#46;22&#37;&#41;&#46; Overweight or obesity was present in 42&#46;6&#37; of patients and tinea pedis was detected in 33&#46;6&#37; of cases&#46; A skin abscess developed in 7&#46;4&#37; of cases&#46; The mean length of admission was 10&#46;20 days&#59; length of stay increased with age and with the erythrocyte sedimentation rate &#40;ESR&#41; on admission &#40;P&#60;&#46;01 for both differences&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">We confirm general epidemiologic factors such as sex and age distributions&#44; predominant site&#44; past history&#44; and length of hospital stay&#46; In view of their predictive value for the length of hospital stay&#44; we propose that age and the ESR on admission should be considered to be indirect indicators of disease severity&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n y objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">ELas erisipelas&#47;celulitis son infecciones cut&#225;neas relativamente frecuentes que en ocasiones requieren una estancia hospitalaria prolongada de los pacientes&#46; Nos proponemos describir los hallazgos epidemiol&#243;gicos m&#225;s relevantes y su influencia en el incremento de la estancia hospitalaria&#44; comparando nuestros resultados con trabajos previos&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; transversal y retrospectivo a partir de un total de 122 pacientes ingresados con el diagn&#243;stico de erisipela&#47;celulitis en el Servicio de Dermatolog&#237;a de nuestro hospital durante un periodo de 5 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Las erisipelas&#47;celulitis constituyeron el 8&#44;6&#37; de todos los casos ingresados durante el periodo estudiado&#46; La edad media fue de 58&#44;93 a&#241;os&#44; con una relaci&#243;n mujer&#58;hombre de 1&#44;06&#46; La localizaci&#243;n m&#225;s frecuente fue las extremidades inferiores con el 76&#44;22&#37; de los casos&#46; El 42&#44;6&#37; present&#243; obesidad o sobrepeso&#59; el 33&#44;6&#37; mostr&#243; ti&#241;a del pie y el 7&#44;4&#37; desarroll&#243; un absceso cut&#225;neo&#46; La estancia hospitalaria media fue de 10&#44;20 d&#237;as&#44; aumentando conforme se incrementaba la edad del paciente &#40;p &#60; 0&#44;01&#41; o el valor de la velocidad de sedimentaci&#243;n globular &#40;VSG&#41; al ingreso &#40;p &#60; 0&#44;01&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Se confirman los preceptos epidemiol&#243;gicos generales acerca de distribuci&#243;n por sexos y edades&#44; localizaciones predilectas&#44; antecedentes y estancia hospitalaria&#46; Se propone considerar el valor de la VSG al ingreso y la edad como un indicador indirecto de la gravedad del cuadro&#44; dado su valor predictivo de la estancia hospitalaria&#46;</p>"
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                            0 => "M&#46;N&#46; Swartz"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "904"
                        "paginaFinal" => "912"
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                    0 => array:1 [
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                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "1990"
                        "volumen" => "29"
                        "paginaInicial" => "459"
                        "paginaFinal" => "467"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2228369"
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                        "paginaFinal" => "311"
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                          "autores" => array:2 [
                            0 => "M&#46; Caetano"
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                        "tituloSerie" => "Acta Med Port"
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                        "paginaInicial" => "385"
                        "paginaFinal" => "393"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16611543"
                            "web" => "Medline"
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                            3 => "S&#46;S&#46; Jones"
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                            0 => "R&#46;T&#46; Lewis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Surg"
                        "fecha" => "1998"
                        "volumen" => "22"
                        "paginaInicial" => "146"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9451929"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bacterial infections&#58; uncommon presentations"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Matz"
                            1 => "E&#46; Orion"
                            2 => "R&#46; Wolf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2005.01.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "503"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16179184"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cellulitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46;L&#46; Goodman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "2522"
                        "paginaFinal" => "2524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15195348"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erysipelas and cellulitis&#58; clinical and microbiological spectrum in an Italian tertiary care hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Lazzarini"
                            1 => "E&#46; Conti"
                            2 => "G&#46; Tositti"
                            3 => "F&#46; de Lalla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jinf.2004.12.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Infect"
                        "fecha" => "2005"
                        "volumen" => "51"
                        "paginaInicial" => "383"
                        "paginaFinal" => "389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16321649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermohypodermites bact&#233;riennes de l&#8217;adulte&#46; Incidence et place de l&#8217;&#233;tiologie streptococcique"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Bernard"
                            1 => "C&#46; Bedane"
                            2 => "M&#46; Mounier"
                            3 => "F&#46; Denis"
                            4 => "J&#46;M&#46; Bonnetblanc"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol"
                        "fecha" => "1995"
                        "volumen" => "122"
                        "paginaInicial" => "495"
                        "paginaFinal" => "500"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8572485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epid&#233;miologie descriptive et connaissance des facteurs de risque de l&#8217;&#233;rysip&#232;le"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Dupuy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol"
                        "fecha" => "2001"
                        "volumen" => "128"
                        "paginaInicial" => "312"
                        "paginaFinal" => "316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11319357"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Streptococcal infections of skin and soft tissues"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;L&#46; Bisno"
                            1 => "D&#46;L&#46; Stevens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199601253340407"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1996"
                        "volumen" => "334"
                        "paginaInicial" => "240"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8532002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erysipelas&#58; changing faces"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Ronnen"
                            1 => "S&#46; Suster"
                            2 => "M&#46; Schewach-Millet"
                            3 => "M&#46; Modan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "1985"
                        "volumen" => "24"
                        "paginaInicial" => "169"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3997339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seasonal variations in streptococcal infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Boycott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1966"
                        "volumen" => "1"
                        "paginaInicial" => "706"
                        "paginaFinal" => "707"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2895238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Carratal&#224;"
                            1 => "B&#46; Ros&#243;n"
                            2 => "N&#46; Fern&#225;ndez-Sab&#233;"
                            3 => "E&#46; Shaw"
                            4 => "O&#46; del R&#237;o"
                            5 => "A&#46; Rivera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10096-003-0902-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Clin Microbiol Infect Dis"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "151"
                        "paginaFinal" => "157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12649712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Crit&#232;res diagnostiques de l&#8217;&#233;rysip&#232;le"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Vaillant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol"
                        "fecha" => "2001"
                        "volumen" => "128"
                        "paginaInicial" => "326"
                        "paginaFinal" => "333"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11319359"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for erysipelas of the leg &#40;cellulitis&#41;&#58; case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Dupuy"
                            1 => "H&#46; Benchikhi"
                            2 => "J&#46;C&#46; Roujeau"
                            3 => "P&#46; Bernard"
                            4 => "L&#46; Vaillant"
                            5 => "O&#46; Chosidow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1999"
                        "volumen" => "318"
                        "paginaInicial" => "1591"
                        "paginaFinal" => "1594"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10364117"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for erysipelas of the leg in Tunisia&#58; a multicenter case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Mokni"
                            1 => "A&#46; Dupuy"
                            2 => "M&#46; Denguezli"
                            3 => "R&#46; Dhaoui"
                            4 => "S&#46; Bouassida"
                            5 => "M&#46; Amri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000090649"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "2006"
                        "volumen" => "212"
                        "paginaInicial" => "108"
                        "paginaFinal" => "112"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16484815"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg&#58; a case-control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;C&#46; Roujeau"
                            1 => "B&#46; Sigurgeirsson"
                            2 => "H&#46;C&#46; Korting"
                            3 => "H&#46; Kerl"
                            4 => "C&#46; Paul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000080853"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology"
                        "fecha" => "2004"
                        "volumen" => "209"
                        "paginaInicial" => "301"
                        "paginaFinal" => "307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15539893"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erysipelas&#58; clinical and bacteriologic spectrum and serological aspects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Eriksson"
                            1 => "C&#46; Jorup-Ronstrom"
                            2 => "K&#46; Karkkonen"
                            3 => "A&#46;C&#46; Sjoblom"
                            4 => "S&#46;E&#46; Holm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1996"
                        "volumen" => "23"
                        "paginaInicial" => "1091"
                        "paginaFinal" => "1098"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8922808"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erysipelas&#58; an update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Chartier"
                            1 => "E&#46; Grosshans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "1996"
                        "volumen" => "35"
                        "paginaInicial" => "779"
                        "paginaFinal" => "781"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8915727"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erysip&#232;le&#58; &#233;volution m&#233;dicale sous traitement&#46; Complications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Crickx"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Dermatol Venereol"
                        "fecha" => "2001"
                        "volumen" => "128"
                        "paginaInicial" => "358"
                        "paginaFinal" => "362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11319365"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1556086415320967"
                          "estado" => "S300"
                          "issn" => "15560864"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent erysipelas&#58; risk factors"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Pavlotsky"
                            1 => "S&#46; Amrani"
                            2 => "H&#46; Trau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges"
                        "fecha" => "2004"
                        "volumen" => "2"
                        "paginaInicial" => "89"
                        "paginaFinal" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16279242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost-effectiveness of blood cultures for adult patients with cellulitis"
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                          "etal" => false
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                            0 => "B&#46; Perl"
                            1 => "N&#46;P&#46; Gottehrer"
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                            4 => "B&#46; Rudensky"
                            5 => "A&#46;M&#46; Yinnon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/313525"
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                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1999"
                        "volumen" => "29"
                        "paginaInicial" => "1483"
                        "paginaFinal" => "1488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10585800"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
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                    0 => array:2 [
                      "titulo" => "Infecci&#243;n subcut&#225;nea necrotizante por Streptococcus agalactiae"
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Vol. 100. Issue 10.
Pages 888-894 (December 2009)
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Vol. 100. Issue 10.
Pages 888-894 (December 2009)
Original articles
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Erysipelas and Cellulitis: A Retrospective Study of 122 Cases
Erisipelas y Celulitis. Estudio Retrospectivo de 122 Casos
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J. Concheiro
Corresponding author
jaime.toribio@usc.es

Correspondence: Departamento de Dermatología. Facultad de Medicina. C/ San Francisco, s/n. 15782 Santiago de Compostela. A Coruña, Spain.
, M. Loureiro, D. González-Vilas, J. García-Gavín, D. Sánchez-Aguilar, J. Toribio
Departamento de Dermatología, Facultad de Medicina, Complejo Hospitalario Universitario, Santiago de Compostela, A Coruña, Spain
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Abstract
Background

Erysipelas and cellulitis are relatively common cutaneous infections that can sometimes be the cause of a prolonged hospital admission. The objective of this study was to determine the most relevant epidemiologic factors and their influence on the length of hospital stay, comparing our results with those of previous studies.

Material and methods

We performed a retrospective, observational, cross-sectional study of 122 patients admitted over a 5-year period to the dermatology department of our hospital with a diagnosis of erysipelas or cell.

Results

Patients with a diagnosis of erysipelas or cellulitis represented 8.6% of all admissions during the study period. The mean age was 58.93 years and the female to male ratio was 1.06:1. The most common site of involvement was on the legs (76.22%). Overweight or obesity was present in 42.6% of patients and tinea pedis was detected in 33.6% of cases. A skin abscess developed in 7.4% of cases. The mean length of admission was 10.20 days; length of stay increased with age and with the erythrocyte sedimentation rate (ESR) on admission (P<.01 for both differences).

Conclusions

We confirm general epidemiologic factors such as sex and age distributions, predominant site, past history, and length of hospital stay. In view of their predictive value for the length of hospital stay, we propose that age and the ESR on admission should be considered to be indirect indicators of disease severity.

Key words:
epidemiology
erysipelas
cellulitis
infection
Resumen
Introducción y objetivos

ELas erisipelas/celulitis son infecciones cutáneas relativamente frecuentes que en ocasiones requieren una estancia hospitalaria prolongada de los pacientes. Nos proponemos describir los hallazgos epidemiológicos más relevantes y su influencia en el incremento de la estancia hospitalaria, comparando nuestros resultados con trabajos previos.

Material y métodos

Estudio observacional, transversal y retrospectivo a partir de un total de 122 pacientes ingresados con el diagnóstico de erisipela/celulitis en el Servicio de Dermatología de nuestro hospital durante un periodo de 5 años.

Resultados

Las erisipelas/celulitis constituyeron el 8,6% de todos los casos ingresados durante el periodo estudiado. La edad media fue de 58,93 años, con una relación mujer:hombre de 1,06. La localización más frecuente fue las extremidades inferiores con el 76,22% de los casos. El 42,6% presentó obesidad o sobrepeso; el 33,6% mostró tiña del pie y el 7,4% desarrolló un absceso cutáneo. La estancia hospitalaria media fue de 10,20 días, aumentando conforme se incrementaba la edad del paciente (p < 0,01) o el valor de la velocidad de sedimentación globular (VSG) al ingreso (p < 0,01).

Conclusiones

Se confirman los preceptos epidemiológicos generales acerca de distribución por sexos y edades, localizaciones predilectas, antecedentes y estancia hospitalaria. Se propone considerar el valor de la VSG al ingreso y la edad como un indicador indirecto de la gravedad del cuadro, dado su valor predictivo de la estancia hospitalaria.

Palabras clave:
epidemiología
erisipela
celulitis
infección
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References
[1.]
M.N. Swartz.
Cellulitis.
N Engl J Med, 350 (2004), pp. 904-912
[2.]
C. Chartier, E. Grosshans.
Erysipelas.
Int J Dermatol, 29 (1990), pp. 459-467
[3.]
E. Grosshans.
Classification anatomoclinique, terminologie.
Ann Dermatol Venereol, 128 (2001), pp. 307-311
[4.]
M. Caetano, I. Amorin.
Erisipela.
Acta Med Port, 18 (2005), pp. 385-393
[5.]
S.L. Dong, K.D. Kelly, R.C. Oland, B.R. Holroyd, B.H. Rowe.
ED management of cellulitis: a review of five urban centers.
Am J Emerg Med, 19 (2001), pp. 535-540
[6.]
S.M. Ellis Simonsen, E.R. van Orman, B.E. Hatch, S.S. Jones, L.H. Gren, K.T. Hegmann, et al.
Cellulitis incidence in a defined population.
Epidemiol Infect, 134 (2006), pp. 293-299
[7.]
F. Denis, C. Martin, M.C. Ploy.
L’érysipèle: données microbiologiques et pathogéniques.
Ann Dermatol Venereol, 128 (2001), pp. 317-325
[8.]
R.T. Lewis.
Soft tissue infections.
World J Surg, 22 (1998), pp. 146-151
[9.]
H. Matz, E. Orion, R. Wolf.
Bacterial infections: uncommon presentations.
Clin Dermatol, 23 (2005), pp. 503-508
[10.]
E.L. Goodman.
Cellulitis.
N Engl J Med, 350 (2004), pp. 2522-2524
[11.]
L. Lazzarini, E. Conti, G. Tositti, F. de Lalla.
Erysipelas and cellulitis: clinical and microbiological spectrum in an Italian tertiary care hospital.
J Infect, 51 (2005), pp. 383-389
[12.]
P. Bernard, C. Bedane, M. Mounier, F. Denis, J.M. Bonnetblanc.
Dermohypodermites bactériennes de l’adulte. Incidence et place de l’étiologie streptococcique.
Ann Dermatol Venereol, 122 (1995), pp. 495-500
[13.]
A. Dupuy.
Epidémiologie descriptive et connaissance des facteurs de risque de l’érysipèle.
Ann Dermatol Venereol, 128 (2001), pp. 312-316
[14.]
A.L. Bisno, D.L. Stevens.
Streptococcal infections of skin and soft tissues.
N Engl J Med, 334 (1996), pp. 240-245
[15.]
M. Ronnen, S. Suster, M. Schewach-Millet, M. Modan.
Erysipelas: changing faces.
Int J Dermatol, 24 (1985), pp. 169-172
[16.]
J.A. Boycott.
Seasonal variations in streptococcal infections.
Lancet, 1 (1966), pp. 706-707
[17.]
J. Carratalà, B. Rosón, N. Fernández-Sabé, E. Shaw, O. del Río, A. Rivera, et al.
Factors associated with complications and mortality in adult patients hospitalized for infectious cellulitis.
Eur J Clin Microbiol Infect Dis, 22 (2003), pp. 151-157
[18.]
L. Vaillant.
Critères diagnostiques de l’érysipèle.
Ann Dermatol Venereol, 128 (2001), pp. 326-333
[19.]
A. Dupuy, H. Benchikhi, J.C. Roujeau, P. Bernard, L. Vaillant, O. Chosidow, et al.
Risk factors for erysipelas of the leg (cellulitis): case-control study.
BMJ, 318 (1999), pp. 1591-1594
[20.]
M. Mokni, A. Dupuy, M. Denguezli, R. Dhaoui, S. Bouassida, M. Amri, et al.
Risk factors for erysipelas of the leg in Tunisia: a multicenter case-control study.
Dermatology, 212 (2006), pp. 108-112
[21.]
J.C. Roujeau, B. Sigurgeirsson, H.C. Korting, H. Kerl, C. Paul.
Chronic dermatomycoses of the foot as risk factors for acute bacterial cellulitis of the leg: a case-control study.
Dermatology, 209 (2004), pp. 301-307
[22.]
B. Eriksson, C. Jorup-Ronstrom, K. Karkkonen, A.C. Sjoblom, S.E. Holm.
Erysipelas: clinical and bacteriologic spectrum and serological aspects.
Clin Infect Dis, 23 (1996), pp. 1091-1098
[23.]
C. Chartier, E. Grosshans.
Erysipelas: an update.
Int J Dermatol, 35 (1996), pp. 779-781
[24.]
B. Crickx.
Erysipèle: évolution médicale sous traitement. Complications.
Ann Dermatol Venereol, 128 (2001), pp. 358-362
[25.]
F. Pavlotsky, S. Amrani, H. Trau.
Recurrent erysipelas: risk factors.
J Dtsch Dermatol Ges, 2 (2004), pp. 89-95
[26.]
B. Perl, N.P. Gottehrer, D. Raveh, Y. Schlesinger, B. Rudensky, A.M. Yinnon.
Cost-effectiveness of blood cultures for adult patients with cellulitis.
Clin Infect Dis, 29 (1999), pp. 1483-1488
[27.]
J.M. Martín, I. Molina, D. Ramón, C. Monteagudo, V. Alonso, E. Jordá.
Infección subcutánea necrotizante por Streptococcus agalactiae.
Actas Dermosifiliogr, 97 (2006), pp. 644-646
[28.]
M. Rodríguez-Vázquez, M. García-Arpa, L. Porras-Leal, G. Romero-Aguilera, P. Cortina-de la Calle, M.D. Romero-Aguilera.
Celulitis atípica asociada a bacteriemia por Campylobacter jejuni en un paciente con hipogammaglobulinemia ligada al cromosoma X.
Actas Dermosifiliogr, 95 (2004), pp. 41-43
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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