Thursday, December 18, 2014

Definition

Impetigo is a superficial skin infection that occurs in nonbullous and bullous (elevated lesions) forms.

Beta-hemolytic streptococcus usually produces nonbullous impetigo. Coagulase-positive staphylococcus aureus usually causes bullous impetigo.

Description

Impetigo is a skin infection seen in all age groups, but it is most common among children. Impetigo is caused by common bacteria, and it often starts as a minor scratch. It is more prevalent during warm weather, particularly among children who live in crowded conditions. The disease can be severe and dangerous in newborn infants.

Impetigo first appears as a sore, often on the upper lip. It may resemble a cold sore or fever blister caused by herpes simplex virus - a virus that can spread by direct contact and may cause serious problems in children. A physician should be contacted to diagnose the condition correctly and treat it accordingly.

A blister may form and, after it breaks, the secretion dries to form a thick, soft, golden crust. When the crust is removed clear, honey-colored fluid oozes from the raw sore. The sores may spread to other parts of the face, hands, or the body.

Impetigo is spread only by direct contact. Parents or caretakers should keep children with active infections away from school and away from other children in the household.

Infected children should not share towels or washcloths with others. The towels, sheets, and clothing of those with impetigo should be thoroughly laundered. The adults taking care of the infected child should wash their hands with soap and water after contact with the lesions.

Causes

This vesiculopustular eruptive disorder is contagious and spreads most easily among infants, young children, and the elderly. Impetigo can complicate chicken pox, eczema, or other skin conditions marked by open lesions.

Risk factors are poor hygiene, anemia, and malnutrition.

Treatment

Generally, treatment consists of systemic antibiotics (usually penicillin, or erythromycin for patients who are allergic to penicillin), which also help prevent glomerulonephritis (inflammation of the kidney that can have serious complications).

Therapy also includes removal of the exudate by washing the lesions two to three times a day with soap and water, or for stubborn crusts, warm soaks or compresses of normal saline or a diluted soap solution before application of topical antibiotics.

Topical antibiotics are less effective than systemic antibiotics. The patient is urged not to scratch since this exacerbates the impetigo. Parents are advised to cut the child's fingernails.

Questions

What is the cause of the impetigo?

What treatment is advised?

Will you prescribe antibiotics?

Should the lesions be washed and how should this be done?

What preventive measures need to be taken so others do not get infected?

What are the possible complications?