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Impetigo // is a highly contagious bacterial skin infection most common among pre-school children. People who play close contact sports such as rugby, American football and wrestling or boxing are also susceptible, regardless of age. Antibiotic creams or pills are often used as a remedy.
Globally impetigo affected approximately 140 million people (2% of the population) in 2010. Impetigo is not as common in adults. The name derives from the Latin impetere ("assail"). It is also known as school sores.
This most common form of impetigo, also called nonbullous impetigo, most often begins as a red sore near the nose or mouth which soon breaks, leaking pus or fluid, and forms a honey-colored scab, followed by a red mark which heals without leaving a scar. Sores are not painful, but may be itchy. Lymph nodes in the affected area may be swollen, but fever is rare. Touching or scratching the sores may easily spread the infection to other parts of the body. Ulcerations with erythema and scarring also may result from scratching or abrading of the skin.
Bullous impetigo, mainly seen in children younger than 2 years, involves painless, fluid-filled blisters, mostly on the arms, legs and trunk, surrounded by red and itchy (but not sore) skin. The blisters may be large or small. After they break, they form yellow scabs.
In this form of impetigo, painful fluid- or pus-filled sores with redness of skin, usually on the arms and legs, become ulcers that penetrate deeper into the dermis. After they break open, they form hard, thick, gray-yellow scabs, which sometimes leave scars. Ecthyma may be accompanied by swollen lymph nodes in the affected area.
It is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes. Both bullous and nonbullous are primarily caused by Staphylococcus aureus, with Streptococcus also commonly being involved in the nonbullous form.
The infection is spread by direct contact with lesions or with nasal carriers. The incubation period is 1–3 days after exposure to Streptococcus and 4–10 days for Staphylococcus. Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.
For generations, the disease was treated with an application of the antiseptic gentian violet. Today, topical or oral antibiotics are usually prescribed. Treatment may involve washing with soap and water and letting the impetigo dry in the air. Mild cases may be treated with bactericidal ointment, such as mupirocin. More severe cases require oral antibiotics, such as dicloxacillin, flucloxacillin or erythromycin. Alternatively amoxicillin combined with clavulanate potassium, cephalosporins (1st generation) and many others may also be used as an antibiotic treatment. Alternatives for people who are seriously allergic to penicillin or infections with MRSA include doxycycline, clindamycin, and SMX-TMP. When streptococci alone are the cause, penicillin is the drug of choice.
Globally impetigo affected approximately 140 million people (2% of the population) in 2010.
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- Photos (University of Iowa)
- Dermnet NZ
- Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition