II. Epidemiology
- Age: Children and Elderly
III. Pathophysiology
- Ulcerative Bacterial Skin Infection (Pyoderma) occurring at minor Skin Trauma sites
- Ecthyma is caused by group A beta-hemolytic streptococcal infection
- Contrast with Impetigo which is caused by Streptococcus or Staphylococcus Aureus
- As with Impetigo, Ecthyma starts as a superficial infection
IV. Risk Factors
- Immunosuppression
- Poor hygiene
- Overcrowded living conditions
- Malnutrition
- Humid environments
- Previously Traumatized skin
V. Signs
- Initial
- Days Later
- Lesions ulcerate into coin size depressed Plaques with raw base and surrounding erythema
- Lesions are covered in central thick brown-gray adherent crusts and dried marginal exudates
- Weeks later
- Untreated ulcers heal spontaneously, but often with secondary scar formation
VI. Differential Diagnosis
- See Skin Infection
-
Impetigo
- Superficial Skin Infections limited to the Stratum Corneum
- Overlying honey colored crusts
- Ecthyma Contagiosum (Parapoxvirus, Orf)
- Localized viral dermal Skin Infection acquired from animal exposure (cattle, goats, sheep)
- Ecthyma Gangrenosum
- Large (>3 cm diameter) papular lesions with hemorrhagic crust
- Due to hematologic spread of Pseudomonas Aeruginosa, in Immunocompromised patients
VII. Management
- Use oral Antibiotics with Gram PositiveAntibiotic coverage (e.g. Cephalexin, Dicloxacillin)
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| Definition (MSH) | An ulcerative pyoderma usually caused by group A beta-hemolytic streptococcal infection at the site of minor trauma. (Dorland, 27th ed) |
| Concepts | Disease or Syndrome (T047) |
| MSH | D004473 |
| ICD10 | L01.09 |
| SnomedCT | 85791004 |
| English | Ecthyma, Ecthymas, ecthyma (diagnosis), ecthyma, Ulcerative impetigo, Ecthyma [Disease/Finding], Ecthyma (disorder), impetigo; ulcerative, ulcerative; impetigo |
| Japanese | 膿瘡, ﾉｳｿｳ |
| Swedish | Ektyma |
| Czech | ektyma, Ektyma |
| Finnish | Ektyyma |
| Russian | EKTIMA, ЭКТИМА |
| Polish | Niesztowica |
| Hungarian | ecthyma |
| Norwegian | Ecthyma, Ektyma |
| Dutch | impetigo; ulceratief, ulceratief; impetigo, ecthyma, Ecthyma |
| Spanish | ectima (trastorno), ectima, Ectima |
| Portuguese | Éctima, Ectima |
| German | Ekthyma, Ecthyma |
| French | Ecthyma |
| Italian | Ectima |
