Classification of Cellulitis

Classification According to Severity and Comorbidities

The Infectious Diseases Society of America (IDSA) classifies skin and soft tissue infections based on purulence, severity, and tissue necrosis, with severity ranging from mild to severe 2, 4
Patients with skin and soft tissue infections can be classified into four classes based on the severity of local signs and symptoms, presence of comorbidities, and affected anatomical layers, with Class 1 being the least severe and Class 4 being the most severe 1, 2, 3

Infections can be classified as superficial, affecting the epidermal and dermal layers, or deep, affecting the subcutaneous tissue, fascial planes, or muscle compartments 1, 2, 3

Infections can be classified as non-necrotizing or necrotizing, with necrotizing infections requiring immediate and aggressive surgical debridement 1, 2

The IDSA/IWGDF classifies diabetic foot infections into four grades, ranging from no infection to severe infection, based on the presence of purulence, inflammation, and tissue necrosis 5

The FDA defines acute bacterial skin and skin structure infections (ABSSSI) as infections with an area of lesion ≥75 cm², including cellulitis, abscesses, and wound infections 1, 2

Infections can be classified as uncomplicated or complicated, with uncomplicated infections being superficial and requiring only antibiotics or incision and drainage, and complicated infections being deep and requiring significant surgical intervention 2, 6, 3
The classification of skin and soft tissue infections is crucial for determining clinical management, treatment, and hospitalization decisions, with signs of deep tissue infection including disproportionate pain, violaceous bullae, and rapid progression [1, 2, 7] [1, 2]