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Barry I. Resnik, M.D.

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Impetigo

ImpetigoImpetigo is a skin infection caused by bacteria and is more common in children suffering from eczema (atopic dermatitis) between the ages of 2 and 6 years. It is caused by bacterial entry into broken skin such as cuts, insect bites, or wounds.

Impetigo is of two forms – bullous impetigo and nonbullous impetigo.

  • Nonbullous impetigo is a common infection in children and is the infection of the upper layer of the skin. Scientific name of nonbullous form is Impetigo contagiosa. Common impetigo is the infection caused by bacteria that gain entry into cuts, wounds or insect bites.
  • Bullous impetigo is a toxin-mediated skin condition in which the top layer of the skin sheds leading to large areas of skin loss.
Causes

Impetigo is most commonly caused by Staphylococcus bacteria, but it also can be caused by group A Streptococcus bacteria. The bacteria enter the body through damaged skin. Other common causes include atopic disease and extreme changes in temperature such as warm and humid temperature.

The infection spreads from one person to another by direct contact with an infected wound or by contact with wound discharge from an infected person.

Symptoms

In nonbullous form, symptoms start with red pimple-like lesions that turn into a vesicle or pus filled sore. This vesicle breaks down leaving a yellow crusted appearance. These sores can occur anywhere on your body, but most commonly occur on the face, especially around the corners of the mouth, the nose and back of the ears, as well as the arms and legs.  

In bullous impetigo small or large, fragile bullae appear that break open and leave the remnants at the site of infection.  Patients with this form of impetigo often suffer from fever, loose stools and weakness in addition to the skin rash. Itching is a common symptom. Lymph nodes of the area may become swollen.

Diagnosis

Your doctor will gather a complete medical history and perform an examination of the skin lesion to make a diagnosis of impetigo. A culture of the skin or lesion is usually recommended to confirm the type of bacteria present in the lesion.

Treatment

Topical mupirocin (Bactroban®) or retapamulin (Altabax®) for a 5 day course is a recommended treatment for nonbullous impetigo.

Oral antibiotics are recommended in extensive involvement or for bullous impetigo. Some of the antibiotics recommended include cephalexin (Keflex®), erythromycin (Ery-Tab®), dicloxacillin (Dycill®) and clindamycin (Cleocin®).

Preventive Tips
  • Avoid contact with other people with cases of impetigo.
  • Keep your skin clean and dry.
  • Avoid scratching on insect bites and injuring your skin.
  • Clean minor wounds with antiseptic soap and clean water.
  • Cut your child’s nails short and encourage them not to scratch their scabs, pick their nose, bite their nails or suck their fingers.

Click here to schedule your consultation with Dr. Resnik

See complete Wikipedia article here.

For more information from the American Academy of Dermatology click here.

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