Dermatitis gangrenosa infantum, also known as ecthyma gangrenosum cachecticorum, or ecthyma terebrans infantum, is a gangrenous disease in skin, often secondary to varicella, measles, or evolves from generalized vaccinia, which is also known as vaccinia gangrenosa.


Causes

Most patients are malnourished infants, mostly after eruption in chickenpox, measles, or vaccination. Patient's low resistance, malnutrition, or poor personal hygiene may be incentives. Dermatitis gangrenosa infantum can also be secondary to infections caused by staphylococcus aureus, streptococcus or pseudomonas aeruginosa.


Signs and Symptoms

Dermatitis gangrenosa infantum occurs mainly in summer and autumn, more common in infants and young children under 3 years of age. Skin lesions are more common in the back, buttocks, abdomen, lower limbs, and head. Erosion and suppuration occur initially in the primary rash, with or without erythema, blisters, pustules, ulceration, and pyorrhea, forming small ulcers, surrounded by inflammatory red halos, with purulent secretions on the surface. Ulcers gradually enlarge and fuse with each other, forming gangrene, eventually leading to tissue necrosis and loss. A deep, round, solid base appears, with a steep necrotic edge. Subjective pain and burning sensation is present. The disease persists for a long time and heals in several weeks or months, leaving scars after healing.

Patients are often accompanied by systemic symptoms, such as abdominal distension, chills, fever, malaise, and exhaustion. In severe cases, it can be complicated by sepsis, even death.


Diagnosis

On the basis of clinical presentations, such as occurrence after other eruptive diseases, pustules, erosion, ulcers, and necrosis, diagnosis is not difficult.


Treatment

Antibiotics can be selected based on bacterial culture and drug sensitivity tests.