Impetigo

What is impetigo ?

  • It is a superficial bacterial infection of the skin often caused by Staphylococcus aureus. Non-bullous impetigo can also be caused by streptococcus (Streptococcus pyogenes).

How does impetigo present ?

  • Itch is almost always present and it presents in two ways:


  • crusted impetigo (non bullous impetigo)

  1. the most common form

  2. presents as honey-colored crusts

  3. It can be localized anywhere, but the periorificial areas (such as around the mouth) are most commonly affected.

  • bullous impetigo

  1. it presents as bullous lesions which easily rupture. (This is due to the bacterial toxin which targets desmoglein 1, the same adhesion molecule as in pemphigus vulgaris)

  2. Like crusted impetigo, It can be localized anywhere, but the periorificial areas (such as around the mouth) are most commonly affected.

What is impetiginization ?

  • It is a bacterial infection appearing on skin conditions.

  • Skin conditions which easily get infected include Atopic Dermatitis and Scabies.

It’s benign so is it ok if not treated ?

  • No, there are complications which arise if no treatment is done (see podcast to see risks per year of having the condition)

Is it contagious ?

  • Yes, quite contagious. 

  • When treated with an oral antibiotic, it is no longer contagious after 24 hours.

How to prevent impetigo ?

  • To prevent recurrence:

  1. Treat carrier sites: apply antiseptic ointment to nostrils

  2. Wash daily with antibacterial soap or soak in a bleach bath

  3. Cut nails and keep hands clean

  4. Identify and treat the source of re-infection, usually another infected person or carrier in the household.


  • To reduce the chance of passing the infection to another person:

  1. Avoid close contact with others

  2. Children must stay away from school until crusts have dried out or for 24 hours after starting oral antibiotics

  3. Use separate towels and flannels

  4. Change and launder clothes and linen daily.


  • Impetiginization also requires an antibacterial therapy: this can be in the form of antiseptics, topical or oral antibiotics.

Further reading

 

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