Front Microbiol 2017 30;8:953. Epub 2017 May 30.

Division of Infectious Diseases, Department of Medical Specialties, Geneva University HospitalsGeneva, Switzerland.

Background: Ecthyma gangrenosum (EG) are necrotic lesions that develop in the context of Pseudomonas aeruginosa bacteremia. Isolated reports describe EG in the setting of non-Pseudomonal infections. In a patient with EG, initial blood cultures showed Escherichia coli, and almost occulted P. Read More

Int J Womens Dermatol 2016 Sep 22;2(3):89-92. Epub 2016 Jul 22.

Departments of Medicine (Division of Infectious Diseases) and Dermatology, University of CT Health Center, Farmington, Connecticut.

Ecthyma gangrenosum (EG) is a well-described skin manifestation of Pseudomonas aeruginosa septicemia in immunocompromised patients. However, it can be seen in association with other bacteria, viruses, and fungi. We report a case of a 54-year-old African American female with metastatic gastric adenocarcinoma and recent chemotherapy and neutropenia who developed EG-like lesions due to methicillin-susceptible Staphylococcus aureus. Read More

J Cutan Med Surg 2017 May 1:1203475417708164. Epub 2017 May 1.

4 University of Missouri Kansas City, Department of Internal Medicine, Kansas City, MO, USA.

Acute cutaneous necrosis is characterised by a wide range of aetiologies and is associated with significant morbidity and mortality, warranting complex considerations in management. Early recognition is imperative in diagnosis and management of sudden gangrenous changes in the skin. This review discusses major causes of cutaneous necrosis, examines the need for early assessment, and integrates techniques related to diagnosis and management. Read More

Rev Chil Pediatr 2017 02;88(1):136-141

Unidad de Paciente Crítico Pediátrico, Clínica Santa María, Santiago, Chile.

Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder.

Objective: To present and discuss 3 infants diagnosed with PID. Read More

Medicine (Baltimore) 2017 Mar;96(10):e6244

aDepartment of Dermatology bDepartment of Urology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang cDepartment of Dermatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.

Rationale: Ecthyma gangrenosum (EG) is an aggressive cutaneous disease caused by local or systemic infection with Pseudomonas aeruginosa. EG is characterized by cutaneous manifestations ranging from nodule and papule, to necrotic ulceration with surrounding erythema, especially with black eschar or central crust. EG presents with characteristic skin lesions which is important to establish diagnosis of sepsis caused by P aeruginosa, a serious condition that can be treated efficiently if diagnosed early. Read More

Clin Exp Dermatol 2017 Apr 27;42(3):324-327. Epub 2017 Feb 27.

Department of Dermatology, St George's Hospital, London, UK.

Ecthyma gangrenosum (EG) is often defined as a cutaneous manifestation of Pseudomonas aeruginosa septicaemia, typically secondary to neutropenia. There is increasing recognition that a broader definition is warranted, as numerous causative organisms and predisposing conditions have been reported. We describe two cases of EG that occurred without bacteraemia. Read More

An Bras Dermatol 2016 Nov-Dec;91(6):815-816

University of Bari - Bari, Italy.

Ecthyma gangrenosum is an uncommon dermatological manifestation characterized by round, indurated ulcers with a central necrotic black eschar and surrounding erythema. This report describes the case of a 5-year-old girl, affected by acute lymphocytic leukemia, presenting with a black eschar on her right thigh. Such lesions should always be correctly identified to avoid potentially fatal bacteraemia. Read More

Medicine (Baltimore) 2017 Jan;96(2):e5507

Pediatric Hospitals of Nice CHU-Lenval, Nice, France.

Rationale: Ecthyma gangrenosum (Eg) is a necrotic lesion that is mostly seen in immunocompromised patients. It reflects a severe sepsis, possibly caused by Pseudomonas aeruginosa (Pa).

Patient Concerns: A healthy 3-year-old girl admitted to the Pediatric Emergency Department presented a sepsis-associated purpura with neurological and respiratory distress. Read More

BMJ Case Rep 2017 Jan 4;2017. Epub 2017 Jan 4.

Department of Internal Medicine (Clinical Hematology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Am J Dermatopathol 2016 Oct 18. Epub 2016 Oct 18.

*Department of Dermatology, Hospital Universitario de la Princesa, Universidad Autónoma, Madrid, Spain; †Department of Dermatology, Fundación Jiménez Diaz, Universidad Autónoma, Madrid, Spain; ‡Department of Dermatology, Hospital Clínico Universitario, Salamanca, Spain; §Dermatopathology Research Unit, Medical University of Graz, Graz, Austria; and ¶Dermatopathologie Laboratory, Friedrichschafen, Germany.

We review the most characteristic clinical and histopathologic findings of the cutaneous manifestations of the occlusive nonvasculitic vasculopathic disorders. Clinically, most of these conditions are characterized by retiform purpura. Histopathologic findings consist of occlusion of the vessel lumina with no vasculitis. Read More

J Assoc Physicians India 2016 Jan;64(1):55

Armed Forces Medical College, Pune.

Rev Chil Pediatr 2016 Sep 27. Epub 2016 Sep 27.

Unidad de Paciente Crítico Pediátrico, Clínica Santa María, Santiago, Chile.

Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder.

Objective: To present and discuss 3 infants diagnosed with PID. Read More

Pediatr Int 2016 Sep;58(9):950-2

Department of Pediatric Gastroenterology, Kent Hospital, İzmir, Turkey.

Ecthyma gangrenosum is a rare, necrotizing, bacterial infection of the skin most commonly caused by Pseudomonas aeruginosa. It has a characteristic clinical picture starting with maculopapular eruption followed by hemorrhagic vesicle and evolving into gangrenous ulcer. Although direct skin inoculation without septicemia is also probable, usually ecthyma gangrenosum is pathognomonic for Pseudomonas septicemia, which has a mortality rate of 38-96%. Read More

Rev Chilena Infectol 2016 Jun;33(3):336-9

Departamento de Medicina Interna, Pontificia Universidad Católica de Chile, Chile.

Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature. Read More

Nefrologia 2016 Sep - Oct;36(5):573-574. Epub 2016 Aug 1.

Servicio de Nefrología, Hospital Universitario de La Princesa, Madrid, España. Electronic address:

Ann Dermatol Venereol 2016 Oct 28;143(10):607-610. Epub 2016 Jul 28.

Service de dermatologie vénéréologie, CHU Yalgado-Ouédraogo, BP 7021, Ouagadougou 03, Burkina Faso; Université Ouaga I, Ouagadougou, Burkina Faso.

Background: Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Read More

Medicine (Baltimore) 2016 Jul;95(29):e4212

aDepartment of Dermatology bDepartment of Vascular Surgery cDepartment of Pathology dDepartment of Infectious Diseases, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

Background: Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive vascular proliferation, clinically characterized by livedoid erythematous-violaceous plaques, which frequently evolve to ulceration and necrosis. Histopathologically, it is manifested by a diffuse proliferation of endothelial cells within the full thickness of the dermis. DDA has been mainly associated with severe peripheral atherosclerosis. Read More

Mycopathologia 2016 Oct 21;181(9-10):759-63. Epub 2016 Jun 21.

CBS-KNAW Fungal Biodiversity Centre, PO Box 85167, 3508 AD, Utrecht, The Netherlands.

Ecthyma gangrenosum (EG) involves necrotic cutaneous lesions caused by bacteria, mainly Pseudomonas aeruginosa, and is usually seen in immunocompromised patients with septicemia. However, clinically similar infections have been published with fungi as etiologic agents. We present a case of an EG-like lesion due to Fusarium oxysporum confirmed by clinical diagnosis, culture and molecular identification and discuss the definition of EG. Read More

Case Rep Med 2016 6;2016:8502150. Epub 2016 Apr 6.

Department of Pediatrics, Division of Neonatology, Yuzuncu Yil University School of Medicine, 65080 Van, Turkey.

Ecthyma gangrenosum is a cutaneous lesion often associated with pseudomonas aeruginosa bacteremia, even though it may develop without bacteremia and may originate from other bacterial and fungal organisms. Pseudomonas aeruginosa bacteremia or sepsis, which mainly affects immunocompromised patients, frequently occurs in hospitals. This lesion typically occurs on the extremities and gluteal and perineal regions. Read More

Turk Pediatri Ars 2016 Mar 1;51(1):46-8. Epub 2016 Mar 1.

Department of Dermatology and Veneral Diseases, Dicle University School of Medicine, Diyarbakır, Turkey.

Ecthyma gangrenosum is a skin lesion associated with Pseudomonas aeruginosa. A previously healthy one-year-old boy who had been diagnosed with varicella 10 days ago was admitted to our hospital with complaints of diarrhea, green ear discharge and new lesions in the diaper area. Intravenous meropenem and amikacin had been previously initiated. Read More

BMJ Case Rep 2016 Mar 30;2016. Epub 2016 Mar 30.

Department of Thoracic Surgery, Hopital de Jolimont, Haine Saint Paul, Belgium.

A 68-year-old woman with a history of breast cancer presented with skin lesions and sternal pain. Clinical examination revealed ulcerative lesions on mastectomy scar and CT scan showed contiguous sternal osteolysis. The main hypothesis was a breast cancer recurrence; however, cutaneous and bone biopsies did not reveal any cancer cells. Read More

Dermatol Online J 2016 Jan 15;22(1). Epub 2016 Jan 15.

University of Texas Southwestern Medical Center.

Disseminated candidiasis in immunosuppressed patients has been classically associated with an erythematous papular eruption, however more severe presentations are possible. We present a patient who developed disseminated Candida tropicalis that presented with hemorrhagic bullae that progressed to large necrotic ulcers. Read More

Indian Dermatol Online J 2016 Jan-Feb;7(1):36-9

Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India.

Ecthyma gangrenosum (EG) is a cutaneous lesion classically associated with potentially fatal Pseudomonas septicemia in immunocompromised patients. Other bacterial and fungal pathogens have also been implicated. Although EG typically occurs in immunocompromised or neutropenic patients, it may occasionally affect a previously healthy person. Read More

Front Med 2016 Mar 3;10(1):101-3. Epub 2016 Mar 3.

Department of Urology, Rush University Medical Center, Chicago, IL, 60612, USA.

A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrotizing soft tissue infection. Read More

Indian J Cancer 2015 Jan-Mar;52(1):79-80

Department of Dermatology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, Karnataka, India.

Pediatr Emerg Care 2016 Jan;32(1):46-8

From the Division of General Pediatrics, The Children's Hospital of Philadelphia, and Department of Pediatrics, Grand View Hospital, Sellersville, PA.

We present the case of a 1-year-old healthy boy who was taking oral antibiotics for an otitis media and then developed an erythematous penile lesion that rapidly became ulcerated. He was admitted to the hospital for further diagnostic studies and intravenous therapy, and his wound culture grew Pseudomonas aeruginosa, consistent with the diagnosis of ecthyma gangrenosum. Serial blood counts also demonstrated a progressive neutropenia, and an immunodeficiency evaluation resulted in the diagnosis of autoimmune neutropenia of childhood. Read More

J Dermatol 2016 Apr 24;43(4):460-2. Epub 2015 Dec 24.

Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.

Acta Dermatovenerol Alp Pannonica Adriat 2015 ;24(4):69-72

Pediatric Surgery Department, Assaf Harofe Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Introduction: We analyzed cases of ecthyma gangrenosum (EG) and "ecthyma-like" or "ecthyma-mimicking" cases of necrotic lesions of the skin to improve current definitions of these conditions.

Methods: The retrospective analysis compared 28 cases of lesions (from 2001 to June 2015) that were identified as EG. Age, sex, lesion location, time from macule to ulcer, underlying diseases, number of lesions per patient, wound bacterial culture, blood culture, and immune status served as variables for analysis and comparison. Read More

Indian J Ophthalmol 2015 Oct;63(10):798-800

Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Ecthyma gangrenosum (EG) is a cutaneous infection which usually occurs in immunocompromised patients. We report a case of EG of the eyelid treated with escharotomy and skin grafting, highlighting the importance of surgical management. A 2-year-old Asian Indian female presented to us with right upper lid edema with a large necrotic area. Read More

Arch Plast Surg 2015 Nov 16;42(6):805-7. Epub 2015 Nov 16.

Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Indian Dermatol Online J 2015 Sep-Oct;6(5):336-8

Department of Clinical Microbiology and Infectious Diseases, Ondokuz Mayis Universty, Samsun, Turkey.

Ecthyma gangrenosum is a rare skin infection caused by Pseudomonas aeruginosa. It is usually seen in immunocompromised and critically ill patients. We report one such case in a previously healthy 20-year old male. Read More

Indian Pediatr 2015 Oct;52(10):896-8

Department of Pediatric Surgery, Dr BC Roy, Post Graduate Institute of Pediatric Sciences (PGIPS); and *Department of Pathology, Institute of Postgraduate Medical Education and Research (IPGMR), Kolkata, West Bengal, India. Correspondence to: Dr Pankaj Halder, SarodaPalli, PanchanonTala, Baruipur, Kolkata 700 144, West Bengal, India.

Background: Outcome of pseudomonas enteric fever is unpredictable as multiple systemic lethal complications occur abruptly.

Case Characteristics: A 9-month-old girl with multiple ileal perforations, leukocoria, ecthyma gangrenosum, hemiplegia and a perforated ulcer in the soft palate. Blood culture suggested Pseudomonas aeruginosa infection. Read More

Pediatr Dermatol 2015 Nov-Dec;32(6):e259-62. Epub 2015 Oct 13.

Department of Dermatology, University of California at San Diego, San Diego, California.

We describe a previously healthy 15-month-old girl who developed ecthyma gangrenosum (EG)-like lesions secondary to methicillin-sensitive Staphylococcus aureus (MSSA). Her systemic symptoms and negative blood cultures suggested MSSA toxin-mediated effects. When toxin-mediated systemic symptoms accompany such lesions, pathogens other than Pseudomonas aeruginosa should be considered. Read More

Pediatr Dermatol 2015 Jul-Aug;32(4):e179-80. Epub 2015 May 4.

Department of Dermatology, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Ecthyma gangrenosum is a characteristic lesion of Pseudomonas aeruginosa sepsis in immunocompromised patients. Only eight cases of ecthyma gangrenosum caused by Escherichia coli have been reported. We report a case of ecthyma gangrenosum due to E. Read More

Actas Dermosifiliogr 2015 Jul-Aug;106(6):510. Epub 2015 Apr 23.

Unidad de Gestión Clínica Dermatología Médico Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, España.

Arch Pediatr 2015 Jun 21;22(6):616-20. Epub 2015 Apr 21.

Department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital, route El Aïn, 3029 Sfax, Tunisia; Faculty of Medecine, Sfax, Tunisia.

Objectives: Pseudomonas aeruginosa sepsis usually carries a high mortality rate in immunocompromised children. Ecthyma gangrenosum is a known cutaneous manifestation due mainly to Pseudomonas infection with or without septicemia. We describe clinical, biological, and therapeutic data. Read More

Acta Dermatovenerol Alp Pannonica Adriat 2015 ;24(1):11-2

Parmova Dermatology Center, Ljubljana, Slovenia.

Ecthyma gangrenosum is a relatively rare cutaneous infection generally thought to be linked to sepsis or bacteremia caused by Pseudomonas aeruginosa in severely ill or otherwise immunocompromised patients. Here we report on a healthy middle-aged couple with a typical ecthyma gangrenosum lesion on their thighs, obviously caused by spreading through intimate contact between two skin surfaces: a sort of "consort kissing ulcer." Although they declined to allow microbiological sampling, the lesions gradually but completely regressed with oral ciprofloxacin treatment, leaving atrophic scars. Read More

J Pediatr Hematol Oncol 2016 Jan;38(1):53-7

*Department of Pediatric Surgery ‡Division of Infectious Diseases and Hospital Epidemiology §Division of Oncology †Children's Research Centre, University Children's Hospital of Zurich, Zurich, Switzerland.

Background: Perianal sepsis with ecthyma gangrenosum is a severe and potentially mutilating complication in immunocompromised children. Therapies include antimicrobial treatment, incision and drainage, generous tissue debridement, and skin transplantation.

Procedure: We describe 3 children with acute lymphoblastic leukemia having sepsis with Pseudomonas aeruginosa in febrile neutropenia and severe perianal infections treated relatively early with a protective colostomy. Read More

Int Wound J 2016 Oct 3;13(5):1049. Epub 2015 Feb 3.

Faculty of Medicine, Division of Neonatology, Atatürk University, Erzurum, Turkey.

Ann Dermatol Venereol 2015 Apr 21;142(4):262-5. Epub 2015 Jan 21.

Dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address:

Background: Ecthyma gangrenosum (EG) is an anatomoclinical syndrome commonly associated with Pseudomonas aeruginosa cutaneous infection. Other microorganisms have also been incriminated on occasion, with other viral, fungal and bacterial agents potentially causing EG. In this report, we present an extremely rare case of an EG caused by methicillin-sensitive Staphylococcus aureus (MSSA) infection. Read More

Glob Pediatr Health 2015 17;2:2333794X15591566. Epub 2015 Jun 17.

Tianjin Children's Hospital, Tianjin, China.

Acta Paediatr 2015 Mar 30;104(3):e134-8. Epub 2015 Jan 30.

Department of Pediatrics, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Unlabelled: Ecthyma gangrenosum (EG) is an uncommon skin lesion that usually develops in patients with known immune deficiency or who are on immunosuppressive treatment. We report on five previously healthy children presenting with EG. Three of them developed severe neutropaenia. Read More

Eur J Clin Microbiol Infect Dis 2015 Apr 19;34(4):633-9. Epub 2014 Nov 19.

Department of Otolaryngology, Assaf HaRofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,

The generally accepted definition of ecthyma gangrenosum (EG) states that this condition is pathognomonic of Pseudomonas septicemia (Pseudomonas aeruginosa) and that it should usually be seen in immunocompromised patients, particularly those with underlying malignant disease. The cases described in the literature present a somewhat different picture. Our objective was to analyze this controversy. Read More

Indian J Cancer 2014 Oct-Dec;51(4):598-9

Department of Dermatology, North Bengal Medical College, Darjeeling, West Bengal, India.

Arch Dis Child 2015 Jan 22;100(1):55-6. Epub 2014 Jul 22.

Pediatric Dermatology Unit, "Ospedale Dell'Angelo", Mestre, Venezia, Italy.

J Am Acad Dermatol 2014 Aug;71(2):e44-5

Children's Mercy Hospitals and Clinics, Kansas City, Missouri.

Kansenshogaku Zasshi 2014 May;88(3 Suppl 9-10):37-9

Ecthyma gangrenosum, presenting as embolic lesions caused by Pseudomonas aeruginosa infection, has distinct pathognomonic features and a high mortality rate in patients with bacteremia, but when recognized early is easily treated. In this case report we describe this disseminated infection in an adult patient treated with chemotherapy for an astrocytoma. Read More

Kansenshogaku Zasshi 2014 May;88(3 Suppl 9-10):33-6

A 67-year-old woman with acute Philadelphia-chromosome-positive mixed phenotype leukemia developed bilateral periorbital ecthyma gangrenousum (EG) subsequent to periorbital edema while undergoing combined imatinib mesylate (imatinib) chemotherapy. Although initial periorbital edema was considered an imatinib side effect, the lesion deteriorated rapidly with high fever in the neutropenic phase, and the woman died of septic shock. Cultures from blood and exudative fluid grew Pseudomonas aeruginosa, after which EG was diagnosed. Read More

Arch Plast Surg 2014 May 12;41(3):299-301. Epub 2014 May 12.

Institute of Reconstructive Plastic Surgery, New York University Langone Medical Center, New York, NY, USA.

Rev Med Chil 2014 Jan;142(1):118-24

Skin necrosis must be considered as a syndrome, because it is a clinical manifestation of different diseases. An early diagnosis is very important to choose the appropriate treatment. Therefore, its causes should be suspected and confirmed quickly. Read More