Ecthyma

Ecthyma is a skin infection analogous to impetigo, but more deeply invasive. As ecthyma extends into the dermis, it is often referred to as a deeper form of impetigo. Ecthyma is the most severe form of impetigo. It happens 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. It is caused by group A beta-hemolytic streptococci. Staphylococcus bacteria can also cause ecthyma.

An ecthyma may initiate with a pus-filled blister, similar to that seen in impetigo. Though, the infection goes through the outer layer of skin (epidermis) and into the deeper layer (dermis). An ulcer with lifted borders develops. Ecthyma is differentiated by small, purulent, shallow, punched-out ulcers with thick, brown-black crusts and encovering erythema. In young lambs, the beginning lesion may arise on the gum below the incisor teeth. The lesions form as papules and progress through vesicular and pustular stages before encrusting.

Ecthyma rarely leads to systemic signs or bacteremia. Lesions are hurtful and can have linked lymphadenopathy. The infection may initiate at the site of an injury, such as a scratch or insect bite, and is often found on the legs. A hard crust which is harder and thicker than the crust of impetigo soon covers this. With problem, the crust can be removed to reveal an indurated ulcer that may be red, swollen and oozing with pus. The lesion frequently occurs within four days of the contact and stays for three to four weeks.

Untreated impetigo which advances to ecthyma most frequently occurs in patients with poor hygiene. The disease must be discriminated from ulcerative dermatosis, which produces tissue destruction and crateriform ulcers. People of all ages, and race can be affected, although children, elderly people and immunocompromised patients tend to have a greater risk of infection.

Causes of Ecthyma

The common causes and risk factor's of Ecthyma include the following:

• A beta-hemolytic streptococci.
• High temperature and humidity.
• Presence of minor injuries or other skin conditions such as scratches, insect bites or dermatitis.
• Staphylococcus bacteria. 
• Untreated impetigo, specifically in patients with poor hygiene.
• It is commoner in hot and humid climates.
• Direct contact with scabs on infected animals.

Symptoms of Ecthyma

Some sign and symptoms related to Ecthyma are as follows:

• Ecthyma lesion frequently begins as a vesicle (small blister) or pustule on an inflamed area of skin.
• Shortness of breath.
• Ecthyma heals slowly, usually with a scar.
• Lesions may be solitary or numerous and are generally 2cm or more in diameter.
• Weakness.
• A crusted ulcer that follows the appearance of the blister.

Treatment of Ecthyma

Here is list of the methods for treating Ecthyma:

• Antibacterials may help fight secondary infection.
• Oral antistaphylococcal agents (eg, dicloxacillin, cephalexin, erythromycin, clindamycin) have been used to cover possible secondary S aureus infections.
• Warm soaks (using a cloth soaked in warm tap water) are helpful for removing crusts.
• Antiseptic soap or peroxide clears of the lesion may be helpful in speeding recovery.
• The topical preparations should be applied tiwce a day routinely, the dressing should be changed daily.

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