Necrotizing erysipelas of the eyelids.

A 72-year-old, healthy white woman presented with rapidly advancing necrotizing erysipelas of the upper and lower eyelids. There was no previous history of trauma or skin abrasions. The patient was treated with intravenous methicillin (Staphcillin) for 2 weeks and oral cloxacillin (Tegopen), for 1 week with intensive wound cleaning and debridement. After 3 months of continuous wound care, the patient has healed her wounds by second intention, with a moderate amount of lid contracture. Further surgical correction of the lower lid defect may be necessary.