Ecthyma is a bacterial skin infection caused by organisms like Pseudomonas, Streptococcus pyogenes, and Staphylococcus aureus. It is more common in hot, humid environments where people live in crowded conditions with poor hygiene. The infection starts as a vesicle or pustule that enlarges and forms a thick crust, underneath which is a purulent ulcer that heals slowly over weeks with scarring. Treatment involves cleansing the skin and applying topical antibiotics as well as taking oral antibiotics together with maintaining proper hygiene and nutrition.

1. ECTHYMA
Dr. Vijay

2. ETIOLOGY
 Psudomonas
 Streptococcus pyogenes
 Staphylococcus aureus

3. PREDISPOSING FACTOR
 High temperature and humidity
 Crowded living conditions
 Poor hygiene
 previously sustained tissue injury
(e.g.excoriations, insect bites, dermatitis)
 immunocompromised (e.g., diabetes,
neutropenia, HIV infection)

4. PATHOPHYSIOLOGY
 Ecthyma is similarly to superficial impetigo
 Difference - impetigo the erosion at the
stratum corneum
in ecthyma the ulcer is full thickness and thus
heals with scarring.

5. Ecthyma
Vesicle or veiscopustule
Enlarge and becomes thickly crusted
Remove crust
Superficial, saucer-shaped ulcer with raw base
and elevated edges
Healing and scar formation (rarely: gangrene)

6. • Ecthyma (ulcerative
impetigo): adherent
crusts, beneath which
purulent irregular ulcers
occur. Healing occurs
after few wks, with
scarring.

7.  Site: more on distal
extremities (thighs &
legs).

8. TREATMENT
 Cleansing with soap and water
Application of Mupirocin or Bacitracin
ointment twice a day
 Oral Dicloxacillin or first-generation
Cephalosporin
 Proper hygiene and nutrition