ECTHYMA By ecthyma we designate an affection closely related to impetigo, in which the ulcerous vesicles—contrary to impetigo—stand on a coarsely infiltrated hypermmic base, healing sooner or later with a pigmented cicatrix.
Pathological first a small hard coarsely infiltrated knot of vivid red color appears; on this a small vesicle appears which soon becomes cloudy. It then ulcerates and in the course of a few clays it dries up and either sinks in or grows peripherally and may attain the size of about a silver dollar. This is surrounded by a hypertemic inflam matory areola, which persists for some time. Healing is rather pro tracted. The ecthyrna pustules are principally at the lower extremities, the nates, rarely at thc trunk. They arc( secondary manifestations and may be regarded as a superficial skin affection which occurs in children of any age by transmission of pus germs as a result of scratching.
cethyma pustules are distinguished from those of impetigo, by a pronounced inflammation of the cutis, which is ac companied by cedema. The papillm are abundantly infiltrated with
leucocytes. Unna looks upon ecthyma as an inflammation of the epidermis with secondary ulceration.
demonstrated the fact that the ecthynia pustule is inoculable: its transmission is unquestionably performed by the staphylo—and streptococci (Leloir).
purposes of differential diagnosis there are prac tically only superficial ulcerous affections to be considered. In con tradistinction to ectliyma the syphilitic crusts are arranged in laminations resembling oyster shells; pruritus and scratch effects are absent. The differentiation from impetigo consists in the absence of the hypermmic indurated infiltrate in the latter affection.
The prognosis is benign.
The treatment corresponds to that of impetigo. One of the princi pal things to be attended to is good nutrition and local cleanliness. The best agents are sulphur baths and sulphur paste bandages.