Ecthyma Gangrenosum in a Pediatric Patient and Review of the Literature

Abstract

Erythema Gangrenosum (EG), is an infective lesion of skin, and mucous membranes typically occurring in patients with chronic disease or immunocompromised patients. İt is a very rarely seen vasculitis with a potentially progressive and fatal course.

An 8-year-old pediatric patient was referred to an external medical center with complaints of fever, abdominal pain, and skin rashes starting 2 days previously, and upon deterioration of his general health state, he was admitted into a surgical intensive care unit with manifestations of septic shock.

In the treatment, all necrotic tissues including skin, and subcutaneous tissue were excised down to a healthy tissue after excision of all necrotic tissue. Vacuum Assisted Closure (VAC) was applied on this area for drainage.

Herein, we aimed to indicate that definitive treatment of a neuropathic child with EG is surgery excision, and also emphasize critical importance of re-excision of newly developed necrotic tissue at an early stage, and close monetarization of the patient.

Keywords

• Ecthyma gangrenosum; abdomen; neutropenic child

Medical Science and Discovery

Öz

References

1. Kryeziu E, Kryeziu K, Bajraktari G, Abazi M, Zylfiu B, Rudhani I, et al. Ecthyma gangrenosum in a patient with acute leukemia. Med Arh. 2010;64:373-374.
2. Fink M, Conrad D, Matthews M, Browning JC. Primary ecthyma gangrenosum as a presenting sign of leukemia in a child. Dermatol Online J. 2012;18:3.
3. Karbuz A, Ozdemir H, Kadıoğlu Şimşek G, Ciftci E, İnce E, Doğru U. Ecythema gangrenosum in a previously healthy child. Turk Arch Ped. 2013;48:68-70.
4. Koo SH, Lee JH, Shin H, Lee JI. Ecthyma gangrenosum in a previously healthy infant. Arch Plast Surg. 2012;39:673 675.
5. Yan W, Li W, Mu C, Wang L. Ecthyma gangrenosum and multiple nodules: Cutaneous manifestations of pseudomonas aeruginosa sepsis in a previously healthy infant. Pediatr Dermatol 2011;28:204 205.
6. Ozkaya O, Uscetin I, Egemen O, Bingöl D,Akan M. Reconstructive procedure of lower lip defect due to ecthyma gangrenosum: A rare complication of acute lymphoblastic leukemia. J Craniofac Surg. 2012;23:182-184.
7. Gonnelli D, Degardin N, Guidicelli T, Londner J, Magalon G, Bardot J. Role of the plastic surgeon in the management of ecthyma gangrenosum in children: Clinical example. Ann Chir Plast Esthet. 2012;57:405-408.
8. Funk E, Ivan D, Gillenwater AM. Ecthyma gangrenosum: An unusual cutaneous manifestation of the head and neck. Arch Otolaryngol Head Neck Surg. 2009;135:818-820.

9. Peña C, Suarez C, Gozalo M, Murillas J, Almirante B, Pomar V, et al. Prospective multicenter study of the impact of carbapenem resistance on mortality in Pseudomonas aeruginosa bloodstream infections. Antimicrob Agents Chemother. 2011;56:1265-1272.
10. Jordan DF, Latkowski JA, Louie E, Chiu ES. Diagnosis and management of ecthyma gangrenosum in chronic renal failure patient. Arch Plast Surg. 2014;41:299-301.
11. Bozkurt I, Yuksel EP, Sunbul M. Ecthyma gangrenosum in a previously healthy patient. Indian Dermatol Online J. 2015;6:336-338.