Ecthyma

• Causes, incidence, and risk factors

  Ecthyma is most often caused by the bacteria streptococcus. Sometimes, staphylococcus bacteria causes this skin infection.

  The infection may start in skin that has been injured due to a scratch or insect bite. It often develops on the legs.

• Symptoms

  The main symptom of ecthyma is a small blister with a red border that may be filled with pus. The blister is similar to that seen in persons with impetigo, but the infection spreads much deeper into the skin.

  After the blister goes away, a crusty ulcer appears.

• Signs and tests

  Your doctor can usually diagnose this condition simply by looking at your skin. In rare cases, the fluid inside the blister may be sent to a lab for closer examination or a skin biopsy may be done.

• Treatment

  Your doctor will usually prescribe antibiotics by mouth (oral antibiotics). Very early cases may be treated with topical medications. More advanced forms may need antibiotics given through a vein (intravenous antibiotics).

  Placing a warm wet cloth over the area can help remove ulcer crusts. Your doctor may recommend antiseptic soap or peroxide washes to speed recovery.

• Expectations (prognosis)

  Unlike impetigo, ecthyma can sometimes result in scarring.

• Complications
  • Spread of infection to other parts of the body
  • Permanent skin damage with scarring
• Calling your health care provider

  Make an appointment with your health care provider if you have symptoms of ecthyma.

• Prevention

  Carefully clean the skin after an injury (such as a bite or scratch). Avoid scratching or digging at scabs and sores.

• References

  Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004.

  Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005.

  Rakel RE. Textbook of Family Practice. 6th ed. Philadelphia, Pa: WB Saunders; 2002.

Review Date: 4/17/2009

Reviewed By: Michael Lehrer, MD, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.