Ferguson L, Chong H, Singh M
Department of Dermatology, St George's Hospital, London, UK.
Department of Cellular Pathology, St George's Hospital, London, UK.
Clin Exp Dermatol. 2017 Apr;42(3):324-327. doi: 10.1111/ced.13064. Epub 2017 Feb 27.
Ecthyma gangrenosum (EG) is often defined as a cutaneous manifestation of Pseudomonas aeruginosa septicaemia, typically secondary to neutropenia. There is increasing recognition that a broader definition is warranted, as numerous causative organisms and predisposing conditions have been reported. We describe two cases of EG that occurred without bacteraemia. In this atypical subset of cases, the skin is thought to represent the primary inoculation site from which haematogenous spread can occur. The first case occurred in the context of human immunodeficiency virus (HIV) infection, a rarely reported association. The evidence base guiding clinicians on management of EG is very limited, particularly in relation to patients with HIV, in whom recurrence risk may be higher than normal. Recurrent EG is described in our second case, in an individual with Good syndrome, a rare association of thymoma and immunodeficiency.
坏疽性脓皮病（EG）通常被定义为铜绿假单胞菌败血症的皮肤表现，通常继发于中性粒细胞减少症。随着越来越多的致病微生物和易感因素被报道，人们越来越认识到需要更广泛的定义。我们描述了两例无菌血症的EG病例。在这种非典型病例中，皮肤被认为是可能发生血行播散的主要接种部位。第一例发生在人类免疫缺陷病毒（HIV）感染的背景下，这是一种鲜有报道的关联情况。指导临床医生治疗EG的证据基础非常有限，尤其是对于HIV患者，他们的复发风险可能高于正常水平。我们的第二例病例描述了一名患有古德综合征（一种罕见的胸腺瘤和免疫缺陷关联疾病）的个体出现复发性EG。
