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Cutaneous cellulitis
1Division of Infectious Diseases, Jefferson Medical College, Philadelphia, Pa 19107.
Insights
Cellulitis infection involves bacterial invasion and the skin's immune response. Intra-epidermal immunocompetent cells and anti-inflammatory agents may help resolve bacterial skin infections.
Area of Science:
- Dermatology
- Immunology
- Microbiology
Background:
- Cellulitis is commonly believed to stem from bacterial invasion and proliferation.
- Difficulty in isolating pathogens from affected skin challenges this traditional hypothesis.
- The skin possesses specialized immune cells capable of secreting cytokines and lymphokines.
Purpose of the Study:
- To investigate the role of the skin's immune microenvironment in cellulitis pathogenesis.
- To explore the contribution of lymphokines and cytokines to cellulitis symptoms.
- To assess the potential impact of anti-inflammatory agents on cellulitis resolution.
Main Methods:
- Review of existing literature on cellulitis and skin immunology.
- Analysis of the proposed mechanisms of bacterial clearance by skin immune cells.
- Examination of the inflammatory mediators involved in cellulitis.
Main Results:
- Skin immune cells (lymphoid and reticular) secrete lymphokines and cytokines.
- These mediators enhance macrophage and neutrophil infiltration, reducing bacterial load.
- Bacterial remnants and amplified lymphokines likely cause cellulitis's characteristic warmth and erythema.
Conclusions:
- Cellulitis pathogenesis involves both bacterial presence and a complex immune response.
- Intra-epidermal immunocompetent cells play a crucial role in managing bacterial skin infections.
- Anti-inflammatory agents may aid in cellulitis treatment by modulating immune mediator production.
Abstract:
Cellulitis has long been postulated to be the result of antecedent bacterial invasion with subsequent bacterial proliferation. Nonetheless, the difficulty in isolating putative pathogens from cellulitic skin has served to cast doubt on this hypothesis. In this regard, the skin is provided with a unique set of lymphoid and reticular cells with the capacity to secrete lymphokines and cytokines. These substances rapidly reduce the number of viable bacteria from infection by enhancing the infiltration of skin by circulating macrophages and neutrophils. The warmth and erythema associated with cellulitis are most likely produced both by a small number of residual bacteria and by fragmented bacterial remnants, and amplified by the lymphokines that are secreted in response to antigenic challenge. Anti-inflammatory agents may play a significant role in enhancing the resolution of infection by reducing the production of soluble mediators by these intra-epidermal immunocompetent cells.