Ecthyma can be seen in patients who are immunocompromised (eg, diabetes, neutropenia).
Ecthyma is a skin infection similar to impetigo. Ecthyma is an ulcerative pyoderma of the skin caused by group A beta haemolytic streptococci. The infection may start at the site of a bug bite or scratch. The infection may start in skin that has been injured due to a scratch or insect bite. It often develops on the legs. It occurs when the infection penetrates deep into the dermis, the skin's second layer, causing painful, itchy sores that develop into pus- or fluid-filled ulcers with hard grayish yellow crusts. The ulcers may cause permanent scarring. Lymph nodes in the affected area may swell. Ecthyma rarely leads to systemic symptoms or bacteremia. Lesions are painful and can have associated lymphadenopathy. Secondary lymphangitis and cellulitis can occur.
The rate of poststreptococcal glomerulonephritis is approximately 1%. Poor hygiene aids spread as does overcrowded living conditions. Presence of minor injuries or other skin conditions such as scratches, insect bites or dermatitis. Ecthyma lesions may remain of constant size and resolve without treatment or they can enlarge to to 3cm in diameter. Treatment depends on the extent and severity of infection. Hygiene is important. Maintain cleanliness by using bactericidal soap and frequently changing bed linens, towels, and clothing. Remove crusts by soaking or using wet compresses and apply an antibiotic ointment daily.
A topical antibiotic ointment such as fucidic acid or mupirocin is often prescribed for localised ecthyma. Topical antibiotics such as mupirocin, fucidic, antibacterial honey, povidone iodine or crystacide are used to the areas affected with this skin disease, on the skin. Penicillin is good antibiotic for treatment of ecthyma. Usually dicloxacillin or flucloxacillin will active for Staphylococcus aureus and Streptococcus pyogenes. Oral antibiotics are recommended if the infection is extensive or proving slow to respond to topical antibiotics. Avoid scratching or digging at scabs and sores. Using separate towels and flannels to prevent spreading infection.Changing and laundering clothes and linen frequently.
1. Penicillin should be adequate to treat ecthyma.
2. Washing daily with antiseptic soap or cleanser.
3. Changing and laundering clothes and linen frequently.
4. Using separate towels and flannels to prevent spreading.
5. Avoid scratching or digging at scabs and sores.
6. Topical therapy with mupirocin ointment for localized ecthyma.
7. Oral antistaphylococcal agents have been used to cover possible secondary S aureus infections.
8. Hygiene is important. Use bactericidal soap and frequently change bed linens, towels, and clothing.
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