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Real Doctors (Life Makers)  |  Clinical  |  Pediatrics  |  Gallery  |  What's this? « previous next »
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Author Topic: What's this?  (Read 6944 times)
dr_b.e.s.m
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What's this?
« on: /November/ 19, 2005, 03:08:53 PM »

Today, it was my first time to hear about this skin condition.

Today, a 2 years old child was referred from peds to dermatology out patient clinic because he had skin lesions on his abdomen.

The patient had hepatospleenomegaly , pancytopenia and was admitted to peds for investigations (suspected leukemia).

This image isn't for the patient but it's very close to it.


* e-g.jpg (9.42 KB - downloaded 33 times.)
« Last Edit: /November/ 19, 2005, 03:36:17 PM by dr_b.e.s.m » Logged


 
dr_b.e.s.m
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What's this?
« Reply #1 on: /November/ 19, 2005, 03:15:18 PM »

It's called ecthyma gangrenosum. And it's different from the ordinary ecthyma.

Here is a hint about it :


The disease, caused by pseudomonal infection, usually occurs in patients with an immune deficit.

Primary lesions: Primary cutaneous lesions of EG initially appear as edematous, well-circumscribed plaques that rapidly become erythematous. A hemorrhagic focus appears in the central area and may fill with blood to form a bulla. The hemorrhagic lesion spreads peripherally and eventually turns into a black necrotic ulcer with an erythematous rim. The transformation of an early lesion to a necrotic ulcer may take place within 12 hours.

Distribution of lesions: EG may appear at any location on the body; however, it commonly appears on the gluteal or perineal region (57%), extremities (30%), trunk (6%), and face (2%).


>> Consider ecthyma gangrenosum in immunocompromised patients who present with purple skin lesions plus fever.

Treatment of EG requires the use of antipseudomonal antibiotic.
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dr_dina
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Re: What's this?
« Reply #2 on: /November/ 20, 2005, 02:54:12 PM »

HI DEAR COLLAGUE
BUT WHY PATIENT HAVE HEPATOSPLENOMEGALLY AND PANCYTOPENIA IS IT RESULT FROM PSEUDOMONAS INFECTION?
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dr_b.e.s.m
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Re: What's this?
« Reply #3 on: /November/ 20, 2005, 05:58:52 PM »

HSM and pancytopenia are due to the haemtological disease he already have .

the pseudomonas infection is secondry to pancytopenia and decreased immunity he had due to the haematological disease.

by the way, the patient is admitted to pediatrics hospital in the haematology unit if you wanna see him? Smiley
« Last Edit: /November/ 23, 2005, 04:09:36 PM by cleo_md » Logged
 
3abeer
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Stair way to paradise


Re: What's this?
« Reply #4 on: /December/ 07, 2005, 06:33:45 AM »

dear dr b.e.s.m

1st of all, thanks 4 ur great effort on the site , well done & all in the mizan inshalla  clapping
2nd, thanks 4 reminding us by this condition, as iremember i saw one kid with EG when i was in peds rotation ,
keep going
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dr_b.e.s.m
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Re: What's this?
« Reply #5 on: /December/ 08, 2005, 05:12:24 AM »

Thanks Dr Abeer for your nice words. I am happy because what I send here is useful and I hope it'll be in mizan insha`allah. Smiley

I sent this topic about EG because I felt that it's important and may be life saving! For example this kid was immunocompromised and had pseudomonas septicemia that was almost occult with no other signs and symptoms ( may be because of his low immunity) then we diagnose and treat this dangerous condition based on a skin lesion that can be missed !



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