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4 January 2005 | Volume 142 Issue 1 | Pages 47-55
For cellulitis that does not respond to conventional antimicrobial treatment, clinicians should consider, among other explanations, several noninfectious disorders that might masquerade as infectious cellulitis. Diseases that commonly masquerade as this condition include thrombophlebitis, contact dermatitis, insect stings, drug reactions, eosinophilic cellulitis (the Wells syndrome), gouty arthritis, carcinoma erysipelatoides, familial Mediterranean fever, and foreign-body reactions. Diseases that uncommonly masquerade as infectious cellulitis include urticaria, lymphedema, lupus erythematosus, sarcoidosis, lymphoma, leukemia, Paget disease, and panniculitis. Clinicians should do an initial diagnostic work-up directed by the findings from a detailed history and complete physical examination. In many cases, skin biopsy is the only tool that helps identify the correct diagnosis. Special tests may also be needed.
Author and Article Information
From Alfa HealthCare, Athens, Greece, and Tufts University School of Medicine, Boston, Massachusetts.
Acknowledgment: The authors thank Dr. Sofia K. Kasiakou for critical review of the manuscript.
Requests for Single Reprints: Matthew E. Falagas, MD, MSc, Alfa HealthCare, 9 Neapoleos Street, 151 23 Marousi, Athens, Greece; e-mail, matthew.falagas{at}tufts.edu.
Current Author Addresses: Drs. Falagas and Vergidis: Alfa HealthCare, 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. REVIEW
Narrative Review: Diseases That Masquerade as Infectious Cellulitis
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