Cellulitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S.


Cellulitis is an acute, spreading infection of the deeper dermis and subcutaneous tissue, usually complicating a wound, ulcer, or dermatosis. It is characterized by rapidly expanding areas of edema, erythema, and warmth, sometimes accompanied by lymphangitis and inflammation of the regional lymph nodes. Unlike erysipelas which affects the upper dermis and the superficial lymphatics, cellulitis lacks sharp demarcation from uninvolved skin and usually does not present with an indurated, "peau d'orange" surface with a raised border. The diagnosis of cellulitis is based on the morphology of lesion and the clinical setting.

Physical Examination

Diagnoses by primary care physicians[1] and hospitalists[2] may be inaccurate and can be improved with consultation by a dermatologist[3]. Common causes of pseudocellulitis are eczematous dermatitis, stasis dermatitis, and erythema chronicum migrans.[3] [4]


  • Redness, warmth, and swelling of the skin may be present
  • Possible drainage, if there is an infection
  • Swollen glands (lymph nodes) near the affected area
  • A health care provider may mark the edges of the redness with a pen, to see if the redness goes past the marked border over the next several days. [5]

Infected left shin in comparison to shin with no sign of symptoms



  1. Weng QY, Raff AB, Cohen JM, Gunasekera N, Okhovat JP, Vedak P; et al. (2016). "Costs and Consequences Associated With Misdiagnosed Lower Extremity Cellulitis". JAMA Dermatol. doi:10.1001/jamadermatol.2016.3816. PMID 27806170.
  2. Cutler TS, Jannat-Khah DP, Kam B, Mages KC, Evans AT (2023). "Prevalence of misdiagnosis of cellulitis: A systematic review and meta-analysis". J Hosp Med. 18 (3): 254–261. doi:10.1002/jhm.12977. PMID 36189619 Check |pmid= value (help).
  3. 3.0 3.1 Arakaki RY, Strazzula L, Woo E, Kroshinsky D (2014). "The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial". JAMA Dermatol. 150 (10): 1056–61. doi:10.1001/jamadermatol.2014.1085. PMID 25143179.
  4. Keller, Emily C.; Tomecki, Kenneth J.; Alraies, M. Chadi (2012). "Distinguishing cellulitis from its mimics". Cleveland Clinic Journal of Medicine. 79 (8): 547–552. doi:10.3949/ccjm.79a.11121. ISSN 0891-1150.
  5. Raff, Adam B.; Kroshinsky, Daniela (2016). "Cellulitis". JAMA. 316 (3): 325. doi:10.1001/jama.2016.8825. ISSN 0098-7484.
  6. 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 6.11 "Public Health Image Library (PHIL)".

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