ually of a septic character, precedes and accompanies the disease; in
almost every instance a fatal termination sooner or later results.

It is possibly a grave type of dermatitis herpetiformis.

#Ecthyma.#

#Give a descriptive definition of ecthyma.#

Ecthyma is a disease characterized by the appearance of one, several or
more discrete, finger-nail-sized, flat, usually markedly inflammatory
pustules.

#Describe the symptoms and course of ecthyma.#

The lesions begin as small, usually pea-sized, pustules; increase
somewhat in area, and when fully developed are dime-sized, or larger,
somewhat flat, with a markedly inflammatory base and areola. At first
yellowish they soon become, from the admixture of blood, reddish, and
dry to brownish crusts, beneath which will be found superficial
excoriations. The individual pustules are usually somewhat acute in
their course, but new lesions may continue to appear from day to day or
week to week. As a rule, not more than five to twenty are present at one
time, and in most cases they are seated on the legs. More or less
pigmentation, and sometimes superficial scarring, may remain to mark the
site of the lesions.

Itching is rarely present, but there may be more or less pain and
tenderness.

#What is the cause of ecthyma?#

It is essentially a disease of the poorly cared-for and ill-fed; the
direct exciting cause is the introduction of pyogenic microorganisms
into the follicular openings. It is closely allied to impetigo
contagiosa, and may in fact be regarded as a markedly inflammatory form
of the latter affection. It seems much less contagious, however. It is
commonly observed in male adults.

#From what diseases is ecthyma to be differentiated?#

From impetigo contagiosa, and the flat pustular syphiloderm.

#How is it distinguished from these several diseases?#

The size, shape, inflammatory action, and the depraved general
condition, the distribution and lesser-contagiousness will distinguish
it from impetigo contagiosa; and the absence of concomitant symptoms of
syphilis, and of positive ulceration, as well as its distribution and
more rapid and inflammatory course, will exclude the pustular
syphiloderm.

#State the prognosis.#

The disease is readily curable, disappearing upon the removal of the
predisposing cause and the employment of local antiseptic applications.

#What treatment is to be advised?#

Good food