Table 3.
Clinical and biological characteristics of cutaneous diphtheria cases. Mainland France, 2018–2022.
| Clinical and microbiological characteristics | |||
|---|---|---|---|
| N = Total response | n = headcount | (p) | |
| Other diagnoses mentioned | 62 | 42 | (67.7) |
| Echtyma | 35 | 8 | (22.9) |
| Burn | 34 | 2 | (5.9) |
| Insect bite | 35 | 3 | (8.6) |
| Impetigo | 34 | 6 | (17.6) |
| Leishmaniasis | 34 | 5 | (14.7) |
| Sporotrichosis | 34 | 1 | (2.9) |
| Pyoderma gangrenosum | 34 | 0 | (0) |
| Buruli ulcer | 34 | 2 | (5.9) |
| Other diagnoses | |||
| Osteitis | 30 | 4 | (13,3) |
| Plantar perforator | 30 | 4 | (13,3) |
| Mycobacteria | 30 | 3 | (10) |
| Syphilis | 30 | 2 | (6,7) |
| Abscess | 30 | 2 | (6,7) |
| Erysipelas | 30 | 2 | (6,7) |
| Necrotizing fasciitis | 30 | 2 | (6,7) |
| Eczema | 30 | 1 | (3,3) |
| Furunculosis | 30 | 1 | (3,3) |
| Pre-existing skin lesion | 60 | ||
| Non | 18 | (30) | |
| Yes | 42 | (70) | |
| Surgical wound | 37 | 10 | (27) |
| Insect bite | 36 | 5 | (13.9) |
| Burn | 36 | 2 | (5.6) |
| Eczema | 35 | 2 | (5.7) |
| Impetigo | 35 | 2 | (5.7) |
| Diabetic foot | 56 | 10 | (17.9) |
| Other pre-existing lesion | |||
| Traumatic wound | 39 | 10 | (25,6) |
| Ulcers (venous/arterial) | 39 | 6 | (15,4) |
| Digital ischaemia | 39 | 1 | (2,6) |
| Pemphigus | 39 | 1 | (2,6) |
| Drug injection point | 39 | 1 | (2,6) |
| Clinical aspect | |||
| Ulcerated lesion | 61 | 50 | (82) |
| Fibrinous | 48 | 34 | (70.8) |
| Clean bottom | 49 | 16 | (32.7) |
| Border of erythematous/purplish ulceration | 48 | 29 | (60.4) |
| Oedema | 55 | 20 | (36.4) |
| Crusty lesion | 56 | 19 | (33.9) |
| Raised border | 47 | 14 | (29.8) |
| Hardened edge | 47 | 14 | (29.8) |
| Peripheral desquamation | 55 | 12 | (21.8) |
| Necrotic lesion | 56 | 9 | (16.1) |
| Pustular lesion | 56 | 9 | (16.1) |
| Papular lesion | 56 | 8 | (14.3) |
| Nodular lesion | 56 | 6 | (10.7) |
| Bed sore | 49 | 5 | (10.2) |
| Vesicular lesion | 56 | 5 | (8.9) |
| Pseudomembrane | 57 | 4 | (7) |
| Panaris | 56 | 1 | (1.8) |
| Other lesion | 50 | ||
| Purulent | 7 | (14) | |
| Bullous | 1 | (2) | |
| Hemorragic | 1 | (2) | |
| Eczema | 1 | (2) | |
| Burgeonning | 1 | (2) | |
| Symptoms associated | |||
| Painful lesion | 57 | 30 | (52.6) |
| Puriginous lesion | 55 | 8 | (14.5) |
| Location of lesions | |||
| Lower limbs | 61 | 53 | (86.9) |
| Upper limbs | 59 | 12 | (20.3) |
| Head | 60 | 6 | (10) |
| Trunk | 59 | 3 | (5.1) |
| Genitals | 59 | 3 | (5.1) |
| Number of lesions | 62 | ||
| 1 | 26 | (41.9) | |
| 2–5 | 22 | (35.5) | |
| >5 | 14 | (22.6) | |
| Size of lesions | 58 | ||
| <1 cm | 15 | (25.9) | |
| 1–5 cm | 28 | (48.3) | |
| >5 cm | 15 | (25.9) | |
| Duration of progression of lesions | 62 | ||
| <1 week | 15 | (24.2) | |
| 1–2 weeks | 9 | (14.5) | |
| 2 weeks to 1 month | 12 | (19.4) | |
| >1 month | 26 | (41.9) | |
| Associated clinical manifestations | 63 | ||
| No | 37 | (58.7) | |
| Yes | 26 | (41.3) | |
| Fever | 26 | 15 | (57.7) |
| Angina/epiglottis | 26 | 0 | (0) |
| Respiratory distress | 26 | 1 | (3.8) |
| Myocarditis | 26 | 0 | (0) |
| Peripheral neuropathy | 26 | 3 | (11.5) |
| Endocarditis | 26 | 0 | (0) |
| Arthritis | 26 | 4 | (15.4) |
| Lymphadenopathy in the drainage area of the lesions | 25 | 7 | (28) |
| Erysipelas | 25 | 3 | (10,1) |
| Osteitis | 25 | 1 | (4) |
| Biological characteristics | |||
| Acute kidney failure | 32 | 4 | (12.5) |
| Neutrophilic polynucleosis | 31 | 12 | (38.7) |
| Increased CRP | 32 | 29 | (90.6) |
| Bacteraemia | 32 | 3 | (9.4) |