Excerpt from Ecthyma

Synonyms, Key Words, and Related Terms: ulcerative pyoderma, cutaneous pyoderma, impetigo, deep impetigo, pyodermic lesion, skin streptococci, group A beta-hemolytic streptococci, group A beta-hemolytic Streptococcus, GABHS, ecthymatous ulcer, ecthymatous ulceration, group A streptococci, GAS, group A Streptococcus

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Background

Ecthyma is an ulcerative pyoderma of the skin caused by group A beta-hemolytic streptococci. Because ecthyma extends into the dermis, it is often referred to as a deeper form of impetigo. See Impetigo for more information.

Pathophysiology

Ecthyma begins similarly to superficial impetigo. Group A beta-hemolytic streptococci may initiate the lesion or may secondarily infect preexisting wounds. Preexisting tissue damage (eg, excoriations, insect bites, dermatitis) and immunocompromised states (eg, diabetes, neutropenia) predispose patients to the development of ecthyma. Spread of skin streptococci is augmented by crowding and poor hygiene.

Frequency

International

The exact incidence worldwide remains unknown.

Mortality/Morbidity

Ecthyma rarely leads to systemic symptoms or bacteremia. Lesions are painful and can have associated lymphadenopathy. Secondary lymphangitis and cellulitis can occur. Ecthyma does heal with scarring. The rate of poststreptococcal glomerulonephritis is approximately 1%.

Race

No racial predisposition is recognized.

Sex

No sexual predisposition is recognized.

Age

Ecthyma has a predilection for children and elderly individuals.

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