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Impetigo is a common, highly infectious skin disease caused by staphylococcus bacteria or more rarely by the streptococcus bacteria. Impetigo, a contagious skin infection that usually produces blisters or sores on the face and hands, is one of the most common skin infections among kids.

Ecthyma is an ulcerative pyoderma of the skin that usually arises on the lower extremities and it is caused by group A beta-hemolytic streptococci. It is a deep form of impetigo as the same bacteria causing the infection are involved but ecthyma causes deeper erosions of the skin.


Staphylococcus aureus and Streptococcus pyogenes can cause superficial infections of the epidermis (impetigo) or extending into the dermis (ecthyma), characterized by crusted erosions or ulcers. The infections may arise as primary infections in minor superficial breaks in the skin or as secondary infections of preexisting dermatoses (impetiginization or secondary infection).


Ecthyma lesion usually begins as a vesicle (small blister) or pustule on an inflamed area of skin. A hard crust that is harder and thicker than the crust of impetigo soon covers this. With difficulty, the crust can be removed to reveal an indurated ulcer that may be red, swollen and oozing with pus. Lesions may stay fixed in size and sometimes resolve spontaneously without treatment, or they may gradually enlarge to a sore of 0.5-3 cm in diameter.

The areas most affected are the buttocks, thighs, legs, ankle and feet. Occasionally, the local lymph nodes become swollen and painful.

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