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Ecthyma Gangrenosum Pictures, Definition, Symptoms, Causes, Treatment

Ecthyma gangrenosum is a skin disease which effects cutaneous layer of skin. It is a bacterial infection which occurs due to a spcific bacteria named pseudomonas bacteraemia. Ecthyma gangrenosum usually occurs in patients who have compromised immune system or patients who are critically ill. Ecthyma gangrenosum appears as bloody pustules which with the passage of time turn in to necrotic ulcers I.e. black in color. Appearance of ecthyma gangrenosum resembles many other skin diseases so proper tests are performed to diagnosis.


Following tests are performed:

Gram stain: in this test fluid from bloody pustule is taken as a sample and test is performed.

Blood Cultures: in this test blood specimens are taken before starting antibiotic therapy.

Skin Biopsy: in this test, a sample of skin is taken from the wound and then observed with various techniques like staining. Skin biopsy sample is further sent for tissue culture.

The histopathological reports of ecthyma gangrenosum shows necrosis of vascular system and each necrotic part is surrounded by few inflammatory cells and various bacteria surrounding it. During gram staining, various gram negative rods are seen around necrotic vessels under microscope. Ecthyma gangrenosum requires prompt diagnosis and treatment should contain appropriate antibiotics.

Ecthyma Gangrenosum Pictures


Ecthyma Gangrenosum Pictures, Definition, Symptoms, Causes, Treatment

Ecthyma Gangrenosum Symptoms


Ecthyma gangrenosum is a cutaneous infection which occurs due to bacteria named pseudomonas bacteraemia. The physical appearance of ecthyma gangrenosum is explained below:

Initially ecthyma gangrenosum lesions are painless red patches which are round in shape. These red patches with the passage of time turn in to red colored bloody (hemorrhagic) pustules. The hemorrhagic part lies in the center forming a blister. This bloody or hemorrhagic blister spread peripherally. Gradually this hemorrhagic blister start turning in to black or grey colored gangrenous ulcer. This ulcer is surrounded by red Halo. It has fastest development like it will take only 12 hours to develop lesion in to necrotic ulcer.

Ecthyma Gangrenosum Causes


Ecthyma gangrenosum occurs in patients with compromised immune system or patients who are critically ill. Immuno compromised patients are more susceptible to pseudomonas and other pathogenic bacterias. There are two mechanical defensive barriers of body i.e. skin and mucosa. When these two barriers breakdown due to any reason, the infectious organisms can easily enter to the body.

Lesions occur due to the invasion of bacteria or other pathogens inside the walls of veins and arteries of skin (specially in subcutaneous layer). Damaged vessels lead to inappropriate blood flow and supply to the parts of body.

Ecthyma Gangrenosum Treatment


As ecthyma gangrenosum is a bacterial infection and occurs due to a specific bacteria named pseudomonas bacteraemia. So antibiotics are the main thing in treatment of this infection. The following antibiotics are recommended for ecthyma gangrenosum.


  • Aztreonam
  • Fluroquinolones
  • Aminoglycosides.
  • Third generation cephalosporins.
  • Piperacillin i.e. anti pseudomonal penicillin. 


During culture testing, piperacillin is prescribed in combination with aminoglycosides. When antibiotics sensitivity results are known the adjustment of antibiotics is necessary. If fungus is reported as a causative agent, then systemic anti fungal therapy is recommended to cover following:

Aspergillus, candida and mucor species.
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