[Relapsing polychondritis as a rare different diagnosis of erysipelas]

Area of Science:

• Rheumatology
• Immunology
• Dermatology

Background:

• Erysipelas is a bacterial skin infection often presenting with localized erythema and swelling.
• Relapsing polychondritis is a rare systemic inflammatory disease affecting cartilaginous structures.

Observation:

• A 76-year-old female presented with painful, erythematous swelling of the right ear.
• Initial treatment for suspected erysipelas with antibiotics was ineffective.
• The patient had a history of recurrent laryngeal and nasal swelling.

Findings:

• The patient's presentation and history raised suspicion for relapsing polychondritis.
• High-dose prednisolone therapy resulted in marked clinical improvement.
• This case highlights the diagnostic challenge in differentiating relapsing polychondritis from erysipelas.

Implications:

• Relapsing polychondritis should be considered in the differential diagnosis of erysipelas, especially in cases unresponsive to antibiotics.
• Early recognition and appropriate immunosuppressive therapy are crucial for managing relapsing polychondritis.
• This case underscores the importance of a thorough patient history in diagnosing rare autoimmune conditions.