Ecthyma Gangrenosum vs Pyoderma Gangrenosum

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Ecthyma Gangrenosum vs Pyoderma Gangrenosum: Two severe skin disorders are Pyoderma Gangrenosum and Ecthyma Gangrenosum. Pseudomonas aeruginosa infections, which produce Ecthyma Gangrenosum, are frequently seen in immunocompromised people. It causes necrotic ulcers to spread quickly, necessitating immediate antibiotic therapy. Conversely, immunological dysregulation causes Pyoderma Gangrenosum, which is linked to systemic illnesses. It manifests as excruciating ulcers that need to be treated with systemic corticosteroids or immunosuppressive medications in addition to treating any underlying illnesses.

Difference Between Ecthyma Gangrenosum and Pyoderma Gangrenosum

Ecthyma Gangrenosum is often associated with Pseudomonas aeruginosa infection in immunocompromised people, whereas Pyoderma Gangrenosum is an uncommon inflammatory skin disorder characterised by painful ulcers with an unknown cause. The table below provides the differences between Ecthyma Gangrenosum and Pyoderma Gangrenosum.


Ecthyma Gangrenosum

Pyoderma Gangrenosum


Primarily bacterial infection (Pseudomonas aeruginosa)

Autoimmune condition

Associated Conditions

Immunocompromised states (neutropenia, leukemia, chemotherapy)

Systemic diseases (inflammatory bowel disease, rheumatoid arthritis, hematological disorders)

Lesion Characteristics

Rapidly progressing painful ulcers with central necrosis and erythema

Painful ulcers with violaceous border, typically deep and enlarging


Necrotizing vasculitis, tissue necrosis, presence of bacteria

Neutrophilic infiltration without evidence of infection


Antibiotics targeting causative bacteria (Pseudomonas aeruginosa), supportive care

Immunosuppressive therapy (corticosteroids, cyclosporine), wound care

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What is Ecthyma Gangrenosum?

Ecthyma Gangrenosum is a rare and serious skin illness caused mostly by Pseudomonas aeruginosa. Immunocompromised people, such as those with reduced immune systems or neutropenia, are the majority of those affected. It begins as little reddish-purple lesions and quickly develops into painful black-centred ulcers, which are frequently found in moist parts of the skin like the armpits or groyne. To stop more problems, prompt diagnosis and treatment are essential. This usually entails intensive antibiotic treatments and supportive measures. Surgical intervention may be required in extreme situations. Close observation and thorough medical management are necessary because of their link to serious underlying medical disorders.

Causes of Ecthyma Gangrenosum 

  • Bacteria: Bacterial infection is typically caused by the bacteria Pseudomonas aeruginosa.
  • Weak Immune System: Those with compromised immune systems, such as those receiving chemotherapy, leukaemia patients, or patients with neutropenia, are frequently considered immunocompromised.
  • Predisposing Factors: Burns, diabetes mellitus, and vascular insufficiency are additional risk factors.
  • Toxins: The toxins produced by Pseudomonas aeruginosa have the potential to cause tissue necrosis.
  • Prompt Diagnosis and Treatment: The management of Ecthyma Gangrenosum and the avoidance of additional problems depend heavily on early recognition and effective antibiotic treatment. 

Symptoms of Ecthyma Gangrenosum 

  • Skin Lesions: The most common symptom is the appearance of little red or purple spots on the skin that rapidly grow into painful, necrotic ulcers.
  • Ulceration: These lesions quickly develop into ulcers that have erythema surrounding them and core necrosis.
  • Central Black Eschar: The ulcer's centre frequently develops a blackened, necrotic area.
  • Pain: Usually, the lesions hurt and are painful.
  • Fever: If the infection is systemic, patients may experience a fever.
  • Systemic Symptoms: Sepsis, hypotension, and organ failure are examples of systemic symptoms that can arise in severe cases, especially in immunocompromised people.

What is Pyoderma Gangrenosum?

Pyoderma Gangrenosum is a rare inflammatory skin condition that causes painful ulcers that spread quickly. Usually starting as little pustules or nodules, these ulcers rapidly grow into big, unevenly shaped lesions with weak margins. Though they usually appear on the legs, they can appear elsewhere on the body. Pyoderma Gangrenosum is frequently linked to underlying systemic conditions such as rheumatoid arthritis, inflammatory bowel illness, or hematologic abnormalities. The clinical presentation is used to make the diagnosis, and other potential causes of skin ulcers are ruled out. The course of treatment often entails treating the underlying ailment, which may need immunosuppressive medication.

Causes of Pyoderma Gangrenosum

  • Immune System Dysfunction: Pyoderma Gangrenosum is classified as an autoimmune disease, meaning that tissue damage and inflammation result from the immune system unintentionally attacking its tissues.
  • Genetic Predisposition: Although it is uncommon, Pyoderma Gangrenosum may be inherited. There may be a genetic component to certain cases, as several reports of cases occurring in families have indicated.
  • Underlying Systemic Diseases: Pyoderma Gangrenosum may be associated with inflammatory bowel disease (such as Crohn's disease or ulcerative colitis), rheumatoid arthritis, autoimmune hepatitis, and hematologic disorders such as myeloproliferative disorders.
  • Trauma or Injury: Surgical wounds, slashes, or burns are examples of trauma locations where Pyoderma Gangrenosum may occasionally develop. It's crucial to remember, though, that Pyoderma Gangrenosum can also develop on its own without any prior trauma.
  • Infection: Although not the primary cause, infections may intensify or precipitate lesions of Pyoderma Gangrenosum. Sometimes the onset of Pyoderma Gangrenosum is preceded by viral or bacterial infections.

Symptoms of Pyoderma Gangrenosum

  • Ulceration: The formation of skin ulcers is the primary sign of Pyoderma Gangrenosum. Usually, these ulcers start as tiny, painful papules or pustules that spread quickly to become painful, deep ulcers with weak borders. The edges of the ulcers may be characterised by a distinctive purple or blue tint.
  • Pain: People who have Pyoderma Gangrenosum ulcers frequently report excruciating pain that feels like a burning or stinging sensation. If there is a lot of pressure or motion where the ulcers reside, the pain could be excruciating and incapacitating.
  • Rapid Progression: Pyoderma Gangrenosum lesions can grow larger and more deeply throughout a short amount of time, often in just a few hours or days. 
  • Undermined Borders: The skin surrounding Pyoderma Gangrenosum ulcers usually looks to be eroded or undermined, giving the ulcers a distinctive punched-out appearance.
  • Size and Shape: Pyoderma Gangrenosum ulcers can vary in size and shape, ranging from small, round lesions to larger, irregularly shaped ulcers. Though they most frequently affect the legs, they can affect any area of the body and manifest as a single lesion or many lesions.

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Similarities Between Ecthyma Gangrenosum and Pyoderma Gangrenosum

  • Skin Lesions: The development of skin lesions is a feature of both illnesses.
  • Ulceration: Both Pyoderma Gangrenosum and Ecthyma Gangrenosum lesions have the potential to develop into ulcers.
  • Necrosis: Tissue necrosis, or the death of afflicted skin tissue, can occur in both situations.
  • Pain: Skin lesions are frequently the source of discomfort for patients with Pyoderma Gangrenosum and Ecthyma Gangrenosum. 

In conclusion, Pyoderma Gangrenosum and Ecthyma Gangrenosum both result in the formation of skin ulcers, but they differ in terms of their underlying causes, clinical manifestations, and modes of therapy. While Pyoderma Gangrenosum is an inflammatory disorder frequently associated with systemic disorders and immunological dysregulation, Ecthyma Gangrenosum is primarily caused by bacterial infection and is related to immunocompromised states.

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What is Ecthyma Gangrenosum?

Ecthyma Gangrenosum is an uncommon but dangerous skin lesion that is usually brought on by a bacterial infection, most frequently caused by Pseudomonas aeruginosa. Immunocompromised people, such as those receiving chemotherapy, neutropenia, or leukaemia, are frequently affected.

What are the symptoms of Ecthyma Gangrenosum?

Skin lesions, which begin as little red or purple spots and quickly develop into painful ulcers with centre necrosis and surrounding erythema, are among the symptoms of Ecthyma Gangrenosum. In severe situations, fever and systemic symptoms may also manifest.

What causes Pyoderma Gangrenosum?

Though its precise aetiology is unknown, Pyoderma Gangrenosum is thought to be an autoimmune disease. It may be linked to systemic illnesses such as rheumatoid arthritis, haematological problems, and inflammatory bowel disease (also known as ulcerative colitis or Crohn's disease).

What are the symptoms of Pyoderma Gangrenosum?

Small pustules or nodules that swiftly develop into painful ulcers with a distinctive violaceous (purple) border are common symptoms of Pyoderma Gangrenosum. These ulcers have the potential to grow deeper over time. Lesions of Pyoderma Gangrenosum usually affect the lower extremities, however they can also appear elsewhere.

What is the primary difference between Ecthyma Gangrenosum and Pyoderma Gangrenosum?

Ecthyma Gangrenosum and Pyoderma Gangrenosum are essentially distinguished by their underlying causes. Pseudomonas aeruginosa is the most frequent bacterial infection that causes Ecthyma Gangrenosum, whereas Pyoderma Gangrenosum is thought to be an autoimmune disorder.