Ecthyma gangrenosum is a skin lesion associated with Pseudomonas aeruginosa. A previously healthy one-year-old boy who had been diagnosed with varicella 10 days ago was admitted to our hospital with complaints of diarrhea, green ear discharge and new lesions in the diaper area. Intravenous meropenem and amikacin had been previously initiated. Physical examination revealed greenish, well bordered necrotic ulcers on both gluteal areas and the perianal area. Pseudomonas aeruginosa grew in wound culture. A colostomy was opened due to recalcitrant diarrhea and ulcers. The patient remitted in one month and was discharged. T lymphocyte subgroups and immunoglobulins were found to be normal on immunologic evaluation. We presented this case to draw attention to the fact that ecthyma gangrenosum due to Pseudomonas aeruginosa may occur in the diaper area and that sepsis due to Pseudomonas should be investigated. (Turk Pediatri Ars 2016; 51: 46-8)
RESUMENUna niña de 12 años fue atendida por presentar pápulas milimétricas diseminadas que involucionaron hacia escaras varioliformes. La prueba de tuberculina fue fuertemente reactiva. Se diagnosticó una tuberculosis pulmonar subyacente y la paciente respondió al tratamiento antituberculoso. La tubercúlide papulonecrótica es una erupción cutánea que se cree debida a hipersensibilidad ante un foco subyacente de tuberculosis y sería un indicador de buen estado inmunitario. Palabras clave: tubercúlide papulonecrótica, tuberculosis cutá-nea, niño. SUMMARYA 12-year-old girl was seen with widespread millimetric papules which resolved leaving varioliform scars. Tuberculin test was strongly reactive. Underlying pulmonary tuberculosis was diagnosed. The patient responded to antituberculous treatment. Papulonecrotic tuberculid is a skin eruption thought to be due to hypersensitivity to an underlying focus of tuberculosis and is an indicator of good immunologic status.
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