Clinical cases
AN UNUSUAL CASE OF ECTHYMA WITH MULTIPLE LESIONS

Pyodermas are frequent bacterial skin infections
favored by immunosuppression, malnutrition and poor
hygiene. Staphylococcus aureus and Streptococcus
pyogenes are most commonly implicated in the pathologic
processes. Several clinical forms have been described
including impetigo, ecthyma, folliculitis, etc. We present
the case of a 43-year-old patient who worked as a shepherd
in Italy. He addressed our clinic for a polymorphic eruption
including papules, pustules and ulcers, with a 5-month
onset. Differential diagnosis included ecthyma, cutaneous
anthrax, brucellosis, leishmaniasis, etc. Laboratory tests
and bacteriological exams detected the presence of germs of
the microbiota, such as Staphylococcus hominis and
Staphylococcus epidermidis. Elevated ASLO serum titer
suggested the diagnosis ofecthyma caused by Streptococcus
pyogenes.