Ecthyma is a skin infection similar to impetigo, but more deeply invasive. Usually caused by a streptococcus infection, ecthyma goes through the outer layer to the deeper layer of skin, possibly causing scars. Ecthyma is the most serious form of impetigo.
CAUSES
The bacterium Streptococcus is the most common infectious organism associated with ecthyma. Staphylococcus bacteria can also cause ecthyma. The infection may start at the site of an injury, such as a scratch or insect bite, and is often found on the legs.
An ecthyma may begin with a pus-filled blister, similar to that seen in impetigo. However, the infection goes through the outer layer of skin and into the deeper layer. An ulcer with raised borders develops. It is covered by a hard crust. Unlike impetigo, ecthyma can sometimes result in scarring.
SYMPTOMS
Ecthyma lesion usually begins as a small blister or pustule on an inflamed area of skin. A hard crust that is harder and thicker than the crust of impetigo soon covers this. With difficulty, the crust can be removed to reveal an indurated ulcer that may be red, swollen and oozing with pus. Lesions may stay fixed in size and sometimes resolve spontaneously without treatment, or they may gradually enlarge to a sore of 0.5-3 cm in diameter. The areas most affected are the buttocks, thighs, legs, ankle and feet. Occasionally, the local lymph nodes become swollen and painful.
TREATMENT
Treatment depends on the extent and severity of infection. Some of the common treatments for Ecthyma are: -
- Warm soaks (using a cloth soaked in warm tap water) are helpful for removing crusts.
- Antiseptic soap or peroxide washes of the lesion may be helpful in hastening recovery.
- Soak a clean cloth in a mixture of half a cup of white vinegar in a liter of tepid water. Apply the compress to moist areas for about ten minutes several times a day. Gently wipe off the crusts.
- A topical antiseptic such as povidone iodine, antibacterial Manuka honey or hydrogen peroxide cream may be used instead. Apply it at least three times a day to the affected areas and surrounding skin.
The duration of treatment varies; several weeks of therapy may be necessary to completely resolve ecthyma.
PREVENTION
Cleanse all injuries or bites, and encourage your child to avoid scratching or digging at them.
