Ecthyma in Adult
Clinically, the lesions of ecthyma appear as vesicles or pustules that ulcerate and crust over. The lower extremities are sites of predilection.
Immunosuppression, poor hygiene, overcrowding, malnutrition, humidity, and pre-existing trauma to the tissues all predispose one to infection. It has also been seen on the lower legs of military trainees in tropical climates. It is more common at the extremes of age.
L08.0 – Pyoderma
762694009 – Ecthyma
Differential Diagnosis & Pitfalls
- The disorder is similar to streptococcal nonbullous impetigo but is differentiated by deeper components.
- Ecthyma should be differentiated from ecthyma gangrenosum, which is caused by Pseudomonas sepsis and is potentially life threatening and evolves over hours to days.
- Methicillin-resistant Staphylococcus aureus (MRSA) infections
- Pyoderma gangrenosum
- Mycobacterium marinum infection
- Cutaneous leishmaniasis
- Insect bite reactions
- Lymphomatoid papulosis
- Papulonecrotic tuberculid
- Venous stasis ulcer or ischemic ulcer
- Haemophilus ducreyi cutaneous ulcers (see chancroid)