Risk factors associated with necrotizing fasciitis of the lower limbs: A multicenter case-control study

Area of Science:

• Dermatology
• Infectious Diseases
• Public Health

Background:

• Necrotizing fasciitis (NF) is a severe soft tissue infection.
• Identifying risk factors is crucial for early detection and management of NF.
• Sub-Saharan Africa presents unique challenges in managing infectious diseases.

Purpose of the Study:

• To identify risk factors associated with necrotizing fasciitis (NF) of the lower limbs.
• To analyze local and general factors contributing to NF development.
• To inform prevention and treatment strategies for NF in the study population.

Main Methods:

• Prospective case-control study conducted in 5 sub-Saharan African countries.
• 159 cases of lower limb NF were matched with 318 controls with leg erysipelas.
• Analysis included local signs and general patient factors.

Main Results:

• Obesity (OR=2.10), diabetes (OR=3.97), nicotine addiction (OR=5.07), NSAID use (OR=7.85), and cosmetic depigmentation (OR=2.29) were independent risk factors for lower limb NF.
• Cutaneous necrosis (83.7%) and pain (75.5%) were primary local signs.
• No significant age difference between cases and controls (P=0.24).

Conclusions:

• NSAID use is a significant risk factor for lower limb NF.
• Voluntary cosmetic depigmentation is identified as a novel risk factor for NF in this population.
• Obesity, diabetes, and nicotine addiction are confirmed overarching risk factors for NF.