Important factors contribute to the development of streptococcal pyodermas or ecthyma. Poor hygiene Untreated impetigo that progresses to ecthyma most frequently occurs in patients with poor hygiene. Prior GAS infection can be detected by anti-DNase beta. Ecthyma lesions show dermal necrosis and inflammation. A deep and superficial granulomatous perivascular infiltrate occurs along with endothelial edema.
Heavy crust covers the surface of the ecthyma ulcer.
Medical treatment depends on progression of lesions. Hygiene is important. Maintain cleanliness by using bactericidal soap and frequently changing bed linens, towels, and clothing. Remove crusts and apply an antibiotic ointment daily. Consider topical therapy with mupirocin ointment for localized ecthyma.