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Risk factors for nonpurulent leg cellulitis: a systematic review and meta-analysis.
M Quirke1, F Ayoub2, A McCabe1
1Emergency Care Research Unit (ECRU), Division of Population Health Sciences (PHS), Royal College of Surgeons in Ireland (RCSI), 123 St Stephens Green, Dublin 2, Ireland.
The British Journal of Dermatology
|November 20, 2016
Summary
Previous cellulitis, leg wounds, ulcers, and edema are key risk factors for developing nonpurulent cellulitis of the leg (NPLC). Localized skin issues significantly increase NPLC risk more than systemic factors.
Area of Science:
- Dermatology
- Infectious Diseases
- Epidemiology
Background:
- Nonpurulent cellulitis of the leg (NPLC) is an acute bacterial skin infection.
- Identifying risk factors for NPLC is crucial for effective prevention and treatment.
Purpose of the Study:
- To systematically review and meta-analyze controlled observational studies on risk factors for NPLC.
- To appraise the quality of evidence for identified risk factors.
Main Methods:
- Systematic literature search of electronic and grey literature sources (July 2015).
- Inclusion of six case-control studies assessed using the Newcastle-Ottawa Scale (NOS).
- Meta-analysis of risk factors using odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- Significant risk factors for NPLC include previous cellulitis (OR 40.3), wounds (OR 19.1), leg ulcers (OR 13.7), and leg edema (OR 6.8).
- Other identified risks: excoriating skin diseases (OR 4.4), tinea pedis (OR 3.2), and obesity (BMI > 30 kg/m², OR 2.4).
- Diabetes, smoking, and alcohol consumption were not significantly associated with NPLC in this review.
Conclusions:
- Local factors like leg edema, wounds, and skin breakdown are more significant predictors of NPLC than systemic factors.
- Clinicians should address modifiable local risk factors during NPLC treatment, including edema, ulcers, and skin infections.
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