Ecthyma gangrenosum

Last Updated: 2020-08-07

Author(s): Anzengruber, Navarini

Ecthyma terebrans.

Ulcers, which are caused by gram-negative bacteria.

Caused by gram-negative bacteria, especially Pseudomonas aeruginosa. Predisposing factors include repeated application of bactericidal agents effective against the Gram‐positive flora, or prolonged maceration favouring the establishment of Pseudomonas even in previously healthy adults.

Single or multiple sharply defined, punched out ulcers.

  • Clinical features
  • Bacteriological confirmation by cultures from the skin lesions or blood.

Mostly the legs are affected, but a manifestation is possible anywhere.

Pseudomonas infection of the toe webs is known as tropical immersion foot, characterized by sharply demarcated areas of maceration and tender erosions.

Topically, an antiseptic or antibiotic treatment should be applied. In a few cases systemic antibiotic therapy is necessary, but can be carried out according to the doctor's instructions.

  1. Korte AKM, Vos JM. Ecthyma Gangrenosum. N Engl J Med. 2017 Dec 7;377(23):e32.
  2. Martínez-Longoria CA, Rosales-Solis GM, Ocampo-Garza J, Guerrero-González GA, Ocampo-Candiani J. Ecthyma gangrenosum: a report of eight cases. An Bras Dermatol. 2017 Sep-Oct;92(5):698-700.