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MSRA Dermatology [3] > [13] Impetigo > Flashcards

[13] Impetigo Flashcards

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Dermatology Board Prep flashcards
1
Q

What is impetigo?

A

A very common superficial infection of the skin

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2
Q

How can impetigo be divided?

A
  • Bullous form

- Non-bullous form

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3
Q

What form of impetigo accounts for the majority of cases?

A

Non-bullous

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4
Q

How else can impetigo be classified?

A
  • Primary

- Secondary

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5
Q

What is primary impetigo?

A

Where impetigo occurs in intact skin

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6
Q

What is secondary impetigo?

A

Where impetigo occurs in skin already affected by another condition

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7
Q

How is impetigo spread?

A

Direct contact with lesions or with nasal carriers

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8
Q

What is the incubation period of impetigo?

A
  • 1-3 days in Streptococcus

- 4-10 days in Staphylococcus

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9
Q

What can cause lesions to spread in the individual?

A

Scratching

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10
Q

What are the common causative organisms of non-bullous impetigo?

A
  • Staphylococcus aureus

- Streptococcus pyogenes

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11
Q

What is an increasingly common cause of non-bullous impetigo?

A

MRSA

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12
Q

What is bullous impetigo invariably caused by?

A

Staph. aureus

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13
Q

What are the risk factors for impetigo?

A
  • Age 2-5
  • Attending school or daycare
  • Diabetes mellitus
  • Dermatitis
  • Immunodeficiency disorders
  • Warm climate
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14
Q

How do non-bullous impetigo lesions present?

A

Tiny pustules or vesicles that evolve into honey-coloured crusted plaques

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15
Q

What is the typical size of the plaques in non-bullous impetigo?

A

< 2cm

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16
Q

Where do non-bullous impetigo lesions usually occur?

A
  • Face (around mouth and nose)

- Extremities (at breaks in the skin)

17
Q

How quickly can non-bullous impetigo spread on the skin?

A

Rapidly

18
Q

What can occur due to auto-inoculation in non-bullous impetigo?

A

Satellite lesions

19
Q

How much erythema and oedema will surround a non-bullous impetigo lesion?

A

Little to none

20
Q

Is non-bullous impetigo itchy?

A

Can be

21
Q

How may regional lymph nodes appear in non-bullous impetigo?

A

Enlarged

22
Q

Describe bullous impetigo lesions

A

Thin roofed bullae that rupture spontaneously with little erythema

23
Q

Where do bullous impetigo lesions usually appear?

A
  • Face
  • Trunk
  • Extremities
  • Buttocks
  • Perineum
24
Q

What is bullous impetigo more likely to occur alongside?

A

Other disease e.g. atopic eczema

25
Q

What other symptoms are often present in bullous impetigo?

A
  • Pain

- Malaise

26
Q

How is impetigo usually diagnosed?

A

Clinically

27
Q

What tests may be useful in managing impetigo?

A

Swabs

28
Q

When may swabs be useful in impetigo?

A
  • Extensive or severe
  • MRSA suspected
  • Recurrent or failing to respond
29
Q

What are the differentials for non-bullous impetigo?

A
  • Contact dermatitis
  • Herpes simplex
  • Discoid lupus
  • Scabies
30
Q

What are the differentials for bullous impetigo?

A
  • Other bullous skin diseases
  • Burns
  • Necrotising fasciitis
31
Q

How can impetigo be managed?

A
  • General advice

- Antibiotics

32
Q

What general advice should be given to patients with impetigo?

A
  • Good hygiene measures

- Stay off school/work until lesions are dry and scabbed over or on antibiotics for 48 hours

33
Q

What good hygiene measures should be followed in impetigo?

A
  • Keep affected area clean
  • Wash hands after touching
  • Don’t share towels or bathwater
  • Avoid scratching
34
Q

If impetigo is mild what antibiotics can be used?

A

Topical fusidic acid TDS for 5 days

35
Q

If impetigo is widespread of bullous what antibiotics can be used?

A

Oral flucloxacillin QDS for 7 days

36
Q

What are the potential compliations of impetigo?

A
  • Cellulitis
  • Lymphangitis
  • Suppurative lymphadenitis
  • Stahpylococcal scalded skin syndrome
37
Q

What are the further potential complications of impetigo caused by Group A beta haemolytic strep?

A
  • Scarlet fever

- Glomerulonephritis

MSRA Dermatology [3] (26 decks)

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