Ecthyma simplex
Last Updated: 2021-10-15
ICD11: 1B73.Z
Last Updated: 2021-10-15
Author(s): Anzengruber F., Navarini A.
ICD11: 1B73.Z
Stokes 1807–1808.
Ecthyma, Ecthyma simplex, Staphylodermia ecthymatosa, Streptodermia ecthymatosa, Ecthyma simplex streptogenes.
Ulcerating, "punched out" ulcers. In and of itself, the term "ecthyma" is a morphological term. A distinction is made between Ecthymata contagiosum (Orf), which is caused by poxviruses, Ecthymata gangraenosum (intertriginous ulcers caused by Pseudomonas aeruginosa) and ulcerations caused by group A streptococci and staphylococci, which are known as ecthymata simplex.
Group A streptococci, more rarely Staphylococcus aureus, penetrate skin via lesions. The most common location is the lower leg, but skin changes can occur at any location.
Initially vesicles and pustules may appear. The pathogens work their way into the subcutaneous tissue, resulting in coin-sized, greasy, purulent, necrotic, punched-out ulcers with halo-like edges, some of which have honey-yellow crusts. Lymphangitis or locoregional lymphadenopathy may be associated.
Eliminate causal factors.
Topical Therapy
Systemic Therapy
Alternatively: Flucloxacillin p.o. or i.m. 3-4x daily 0.5-1.0 g.
Alternatively: Cefazolin i.v. 1-2 g twice daily (adults), 25-100 mg/kg bw/d in 3-4 single doses (children > 1 month)
Alternatively: Cefixim p.o. 400 mg once daily (≥12 yrs), 8 mg/kg bw/d once daily (<12 yrs)
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