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)