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When to Suspect Necrotizing Fasciitis
Use this ABCDE mnemonic to distinguishnecrotizing fasciitis, which usuallyrequires surgery, from cellulitis,which can be treated with antibioticsalone:
Use this ABCDE mnemonic to distinguish necrotizing fasciitis, which usually requires surgery, from cellulitis, which can be treated with antibiotics alone:
Adenitis (also lymphangitis).
Bullae.
Crepitus.
Dishwater-colored fluid discharge.
Edema greater than erythema.
Other signs of necrotizing fasciitis include compartments that are not soft, rapid progression of symptoms, severe pain, laboratory abnormalities (such as those associated with early disseminated intravascular coagulation, an elevated creatine kinase level, or a low bicarbonate level), and a sickly appearance. Plain radiographs to detect subcutaneous gas and CT of the affected and unaffected side to detect asymmetry can also be helpful.
-- D. Brady Pregerson, MD
Los Angeles
FDA Approves Guselkumab for Pediatric Plaque Psoriasis and Active Psoriatic Arthritis
September 30th 2025The FDA has approved guselkumab for children aged 6 years and older with moderate to severe plaque psoriasis or active psoriatic arthritis, making it the first IL-23 inhibitor authorized for pediatric use.
