Derm - Impetigo

Question 1

What causes impetigo?

Answer 1

Staphylococcus aureus
Golden crust is characteristic

Streptococcus pyogenes

Question 2

What advice should be given to parents about impetigo?

Answer 2

Contagious

Children should be kept off school until lesions heal or 48 hours after antibiotics

Don’t touch of scratch lesions

Question 3

Where does non-bullous impetigo occur?

Answer 3

Around nose or mouth

Exudate from lesions dries forming golden crust

Question 4

How can non-bullous impetigo be treated?

Answer 4

Topical fusidic acid

Antiseptic cream (hydrogen peroxide 1%) first line before antibiotics

Oral flucloxacillin if more wide-spread or severe impetigo

Question 5

What causes bullous impetigo?

Answer 5

Always staphylococcus aureus

Epidermolytic toxins break down proteins holding together skin

This causes fluid filled vesicles to form, vesicles grow in size and eventually burst, heals without scarring

Lesions can be painful and itchy

Question 6

What type of impetigo is more common in children under 2?

Answer 6

Bullous impetigo

Can also occur in adults

Question 7

What is severe bullous impetigo called?

Answer 7

Staphylococcus scalded skin syndrome

Question 8

What can be used to confirm diagnosis of bullous impetigo?

Answer 8

Swabs of vesicles

Question 9

How is bullous impetigo usually treated?

Answer 9

Flucloxacillin orally
IV if unwell or at risk of complications

Question 10

What advice should be given in bullous impetigo?

Answer 10

Highly contagious and patients should be isolated

Question 11

What are the potential complications of impetigo?

Answer 11

Cellulitis
Sepsis
Scarring
Post streptococcal glomerulonephritis
Staphylococcus scalded skin syndrome
Scarlet fever