Ecthyma gangrenosum is a skin manifestation of systemic sepsis commonly caused by
Pseudomonas aeruginosa
in patients with neutropenia or underlying immune deficiency. Although the usual outcome is poor, early recognition and appropriate systemic antibiotic treatment can lead to successful outcome. We report a case of a previously healthy lady with no apparent immune deficiency or neutropenia who had ecthyma gangrenosum of left lower limb in which the arterial line was placed.