Ecthyma gangrenosum in Saudi Arabia.
We report a diagnosis of ecthyma gangrenosum EG in 4 females of mean age 54.8 range 43-64 years, within 10 months. Severe drug reaction treated with high dose systemic corticosteroids in patient one, acute myelocytic leukemia treated with high dose dexamethasone, and multiple broad-spectrum antibiotics in patient 2 preceded the onset of EG. Patients 3 and 4 had vasculitic purpura and hemodialysis. In addition, patient 3 was receiving multiple broad-spectrum antibiotics plus anti-tuberculosis TB drugs for gastric TB, while patient 4 was on melphalan and high dose systemic corticosteroids. Pseudomonas aeruginosa was isolated from blood culture of the first 3 patients, and skin culture of patient one. Blister aspirate from patient 4 yielded Candida albicans. Factors enhancing skin invasion by pathogenic organisms in our patients were breached skin integrity, therapy with high dose corticosteroids and multiple broad-spectrum antibiotics, hematologic malignancies and chemotherapy with severe neutropenia.
Obasi
Obasi E
OE
Department of Dermatology, King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia. oeobasi@hotmail.com
Osoba
Abimbola O
AO
Raddadi
Ali A
AA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D004473:Ecthyma / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005734:Gangrene; D006801:Humans; D008875:Middle Aged; D012529:Saudi Arabia
D000900:Anti-Bacterial Agents