[Common skin and soft tissue infections-current recommendations]

Abscesses, erysipelas, or uncomplicated skin and soft tissue infections (phlegmons) are common soft tissue infections encountered by dermatologists. Their definition, diagnosis, and treatment are summarized here based on the updated German-language guidelines. Cutaneous abscesses are encapsulated, pus-filled cavities which, depending on their location in deep or superficial skin-layers, cause solid to fluctuating, more or less erythematous, painful swelling under usually intact epidermis. Superficial and mature abscesses reveal visible collection of pus. Primary and often sufficient therapy consists of incision and drainage. In the presence of complicating factors, an antibiotic targeting Staphylococcus (S.) aureus is additionally recommended. Erysipelas, caused by streptococci, is characterized by bright-red, often shiny erythema with sometimes arched margins, which is initially accompanied by constitutional symptoms such as shivers or fever. The treatment of choice is penicillin. An uncomplicated soft tissue infection is usually caused by S. aureus and is characterized by a livid red erythema with slight edema and blurred margins. Constitutional symptoms do not generally occur and sometimes only in the course of infection. They are sufficiently treated with, e.g., oral cefadroxil or intravenous cefazolin. Complicated soft tissue infections are extensive infections of soft tissue due to certain comorbidities, such as severe diabetes, immunosuppression, liver or kidney failure or to complicating factors such as burns or injuries with foreign bodies. The spectrum of causative bacteria is broader and must be considered for calculated antibiotic therapy. This review is intended to provide targeted and successful antibiotic therapy and to reduce adverse effects and development of resistant bacteria.