Ulcerative impetigo- Ecthyma - Multiple ulcers with a raised border. Ecthyma = Ulcerative Impetigo, mainly caused by Streptococci infection but also by Staphylococci infection. Ecthyma is a deeper skin lesion (infection) than impetigo.
Ecthyma: S. aureus A large, circumscribed chronic ulcer with surrounding erythema in the pretibial region.
Ecthyma, which is most common on the leg, is due to bacterial infection penetrating through the epidermis to the dermis causing a necrotic lesion with a superficial crust and surrounding inflammation. Both streptococci and staphylococci are responsible.
Clinical presentation—points to note • In any patient with a localised area of acute erythema, swelling, and fever—consider infection. • Remember that a generalised erythematous rash may be the manifestation of a localised infection. Scarlet fever arises from streptococcal sore throat, and herpes simplex of the lip may be associated with erythema multiforme. • The common pathogens are also commensals—recent studies showed that 69% of individuals are nasal carriers of Staphylococcus aureus and some may carry Group A streptococci in the throat.