Impetigo
Impetigo is an easily transmitted vesiculopustular infection of the skin that predominantly affects children. Infections usually occur on areas of the face and extremities. Impetigo is associated with warm, humid conditions, poverty, crowding, and poor personal hygiene and is easily spread within families. Impetigo infections can develop after insect bites or abrasions and are typically caused by Staphylococcus aureus and group A streptococci.
More rare forms of impetigo include an ulcerative form, called ecthyma, and bullous impetigo. Bullous impetigo causes lesions to form and subsequently drain, leaving a nonpurulent crust.
Clinical Features
Local
- Vesiculopustular lesions
- Thick, honey-colored crust, which forms after vesiculopustules rupture
- Multiple lesion
- Local lymphadenopathy
Diagnosis
In addition to evaluating the appearance of the skin, bacterial cultures are conducted to determine the infecting microbe.
Treatment
Patients with limited lesions are treated with a topical antibiotic, such as mupirocin. There are limited data to suggest that, in this population, topical antibiotics are preferable to oral. In some cases, treatment of the anterior nares with mupirocin ointment is recommended. When impetigo infections become severe, oral antibiotics, such as penicillin, are given. Patients are encouraged to practice basic hygiene and apply warm compresses to remove crust.
