Ecthyma gangrenosum without bacteraemia in a leukaemic patient

Ecthyma gangrenosum is a well recognized cutaneous manifestation of Pseudom onas aeruginosa infections in immunocompromised patients. Most cases of ect hyma gangrenosum have been associated with concomitant septicaemia. However . ecthyma gangrenosum rarely develops due to Ps. aeruginosa in the absence of bacteraemia. We report a rare case of a nonsepticaemic form of ecthyma g angrenosum presenting as a large solitary necrotic ulcer in a patient with acute myelogenous leukaemia. A culture from the lesion revealed the presenc e of Ps. aeruginosa, but the results of repeated blood cultures were negati ve. Histological examination revealed numerous tiny eosinophilic bacilli in the dermis and panniculus with Gram's stain.