When you're immunocompromised, you're at risk of a lot of different infections, including skin infections. One skin infection that you may develop is ecthyma gangrenosum. Here are four things that you need to know about this infection.
What are the signs of ecthyma gangrenosum?
If you have this skin infection, you will notice a red, swollen bump or blister on your skin. The lesion can form anywhere, but usually, the armpits, arms, legs, groin, or buttocks will be affected. This lesion will quickly turn into an ulcer (an open sore) with a black center and a red, swollen rim. At this point, you will also have a fever due to the infection. If you notice a lesion that fits this description, you need to see a dermatologist immediately.
What causes this infection?
Ecthyma gangrenosum is caused by Pseudomonas aeruginosa, a type of bacteria. This bacteria is widespread and can be found in soil, water, and even on human skin. Most of the time, this infection is seen in immunocompromised people; immunocompetent people are generally able to fight off the bacteria.
How serious is it?
This infection is very serious. The infection cuts off the circulation to the affected skin, leading to necrosis. If not treated, the infection will continue to spread and more skin will be destroyed. Worse, the infection may reach your blood, leading to septicemia. Mortality rates between 18% and 96% have been reported in people who have the bacteria in their blood. If the bacteria doesn't reach your blood, mortality rates of 15.4% have been reported.
How is it treated?
This skin infection is treated with antibiotics. If antibiotics alone are not enough, the lesions may need to be surgically removed. Your dermatologist will need to refer you to a surgeon if this needs to be done. The surgeon will remove all of the infected or dead tissue and leave only your healthy tissue behind.
Once you've recovered, you may be left with a large scar at the site of your lesion, but a dermatologist, like Henry E. Wiley, III, M.D., can help you manage the cosmetic issues associated with a scar. Your dermatologist may prescribe a lightening cream for you to rub on the scar to help camouflage it. You may also be given injections of cortisone to soften and shrink your scar tissue. Cosmetic treatments such as dermabrasion or chemical peels that remove the top layer of your skin can also be used; after these treatments, the top layer of skin will heal and look smoother and less scarred.
If you think you have ecthyma gangrenosum, seek medical attention right away.