Ecthyma gangrenosum: a cutaneous manifestation of Pseudomonas aeruginosa sepsis.

cosa with vomiting, as occurred in our patient, is a unique presentation of esophageal involvement. Esophageal lesions were limited to the distal esophagus in three patientsv" and to the upper esophagus in one patient." They consisted of a single or multiple erosions. Involvement of the major part of the esophagus, as in our patient, has been reported only once"; endoscopy showed erythema with white plaques overlying denuded mucosa throughout the esophagus. Histologic examination was performed in three patients and showed superficial necrosis of the epithelium with inflammatory cells.i-" Buccal lesions were present in four patients. In two patients, the illness was fatal, whereas in two others esophageal stricture developed. 5, 7 Stevens-Johnson syndrome may be precipitated by various drugs. I Aspirin has been occasionally incriminated.f Two of the six reported patients had taken aspirin (in association with other medications) before erythema multiforme began.f 7 Because cutaneous, buccal, and esophageal lesions have similar clinical and histologic features, esophageal involveJournal of the American Academy of Dermatology July 1993