Ecthyma: causes, symptoms, diagnosis, treatment

Ecthyma is a deep streptococcal ulcerative lesion of the skin.

At the onset of the disease, a large, hazelnut-sized, single pustule with serous-purulent contents appears, after which a deep ulcer is formed, covered with a dense purulent crust of brown-brown color. The ulcer has steeply elevated edges, a purulent soft bottom and is surrounded by a shaft of inflammatory painful infiltrate. Usually, after 3-4 weeks, the ulcer is filled with granulation tissue and heals with the formation of a scar. Ecthyma is often found on the shins, less often on the buttocks and trunk.

Differential diagnosis is carried out with syphilitic ecthymas, which do not have a pronounced acute inflammatory component; serological reactions to syphilis and a study on pale treponema are positive.

Treatment of ecthyma. Broad-spectrum antibiotics are prescribed (lincomycin, cephalexin, etc.). Ciprofloxacin (Syspres) is effective, one tablet 2 times a day. In the gangrenous form, corticosteroids (30-50 mg / day), angioprotectors are added; proteflazid (15-20J drops 2 times a day), which has an immunocorrective, antioxidant effect. Trypsin, chymopsin (to cleanse the ulcer from pus), then solcoseryl mixed with antibiotics are applied externally to the ulcer, 20% ichthyol ointment, ichthyol-camphor ointment, vinylin, etc. are applied to the surrounding infiltrate. UHF, UV, laser therapy are indicated.

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