What Is Vulvar Erysipelas?

Erysipelas of the vulva is a relatively unfamiliar condition to most people, and consequently, the general population has limited awareness or understanding of it. So, what exactly is erysipelas of the vulva?

What Is Erysipelas of the Vulva?

Erysipelas of the vulva is an acute inflammatory condition affecting the skin, subcutaneous tissues, lymphatic vessels, and surrounding structures, caused by hemolytic streptococci. It typically occurs when bacteria invade through breaks or injuries in the vulvar skin or mucosa; in rare cases, it may result from hematogenous (blood-borne) infection. Clinically, vulvar erysipelas presents abruptly and is usually unilateral. Early symptoms often include chills, fever, headache, nausea, and vomiting. Subsequently, a rash develops—initially appearing as nodular erythematous plaques—which rapidly spreads peripherally, forming sharply demarcated, edematous, erythematous plaques associated with localized redness, swelling, warmth, and tenderness.

In severe cases, the overlying skin exhibits marked burning sensation and tense, shiny, exquisitely tender edema. Bilateral inguinal lymphadenopathy with tenderness is commonly observed. Symptoms typically peak within 3–5 days; as inflammation subsides, mild post-inflammatory hyperpigmentation and desquamation may persist at the affected site. In more severe cases, systemic toxicity and thrombosis may develop due to bacterial dissemination and toxin effects—manifesting as complications such as glomerulonephritis, myocarditis, or cavernous sinus thrombosis.

Clinically, erysipelas of the vulva is primarily managed with targeted antibiotic therapy. Antibiotics must be initiated early, administered in adequate doses, and selected for high efficacy to alleviate systemic symptoms, control local inflammation, and prevent recurrence. Penicillin or cephalosporins are first-line anti-inflammatory agents. For patients allergic to penicillin or cephalosporins, erythromycin may be used as an alternative anti-inflammatory treatment. We hope this information proves helpful to you!