Causes of Pseudocellulitis - Differential Diagnosis Framework for Cellulitis Mimics



Cellulitis: Deep skin and subcutaneous fat infection



Pseudo Cellulitis:

 • Uncomplicated non-necrotizing inflammation of the dermis and hypodermis from a non-infectious etiology. However, many non-infectious entities can mimic cellulitis and must be differentiated. 

 • Imperative to diagnose to avoid unnecessary antibiotics and avoid allergic reactions, C. diff, change in host flora, and substantial health care spending. 

 • Early consult by dermatologists represents a cost-effective intervention and reduces inappropriate antibiotic use and hospitalization.

 • Tetrad of key physical findings:

	- Rubor, Dolor, Calor, and Rumor are non-specific markers of inflammation.

 • Misdiagnosis as high as 28% in US hospitals.



Inflammatory Causes of Pseudocellulitis:

 • Drug reaction

 • Contact dermatitis

 • Angioedema

 • Sweet syndrome

 • Gout

 • Acute bursitis

 • Erythema nodosum

 • Pyoderma gangrenosum

 • Sarcoidosis

 • Eosinophilic cellulitis

 • Panniculitis

 • Polyarthritis nodosum

 • Erythema migrans



Vascular Causes of Pseudocellulitis:

 • Venous stasis

 • Stasis dermatitis

 • Lymphedema

 • DVT

 • Superficial thrombophlebitis

 • Hematoma

 • Erythromelalgia

 • Calciphylaxis

 • Superficial migratory thrombophlebitis



Neoplastic Causes of Pseudocellulitis:

 • Lymphoma

 • Leukemia

 • Carcinoid erysipelas

 • Inflammatory carcinoma - Lung, Pancreatic, GI

 • Paraneoplastic



Miscellaneous Causes of Pseudocellulitis:

 • Insect bites/stings

 • Foreign body implant

 • Coma bullae

 • Compartment syndrome

 • IV infiltration



By Dr. Ravi Singh @rav7ks



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