Impetigo Flashcards
What is impetigo?
A localised, highly contagious, staphylococcal or streptococcal skin infection
Who is impetigo most common in?
Infants and young children
What can impetigo be divided into?
Bullous and non-bullous forms
Which type are the majority of impetigo cases?
Non-bullous
What are the common causative organisms of non-bullous impetigo?
- Stahpylococcus aureus
- Streptococcus pyogenes
What is an increasingly common cause of non-bullous impetigo?
MRSA
What is bullous impetigo most commonly caused by?
Staph aureus
What are the risk factors for impetigo?
- Pre-existing skin disease e.g. eczema
- Poor hygiene
- Breach in skin e.g. bites, trauma, chickenpox
How does non-bullous impetigo present?
Tiny pustules or vesicles that evolve rapidly into honey coloured plaques under 2cm in diameter
Where does non-bullous impetigo typically affect?
The face but also on extremities where skin breaks have occured
What may surround a non-bullous impetigo lesion?
Satellite lesions due to autoincoulation
What secondary symptoms may be present in non-bullous impetigo?
- Itching
- Regional lymphadenopathy
How does bullous impetigo appear?
Thin roofed bullae that rupture spontaneously with little eryhtema
Where does bullous impetigo typically affect?
Face, trunk, extremities, buttocks or perineal regions
What secondary symptoms might present with bullous impetigo?
- Painful
- Malaise
How is impetigo typically diagnosed?
Clinically
When might swabs and cultures be necessary in impetigo?
- Extensive or severe
- MRSA suspected
- Recurrent or not responding to treatment
What are the differentials fo impetigo?
- Contact dermatitis
- Scabies
- Various viral skin infections e.g. herpes, VZV
- Atopic eczema
- Burns
- Stevens Johnson Syndrome
What are the general advice measures in impetigo?
- Stay off school until lesions are dry and scabbed
- Keep area clean
- Wash hands
- Avoid sharing towels
What medication can be helpful in some mild cases?
Topical antibiotics e.g. mupirocin
When are oral antibiotics required?
In severe cases that are extensive or resistant to treatment
Which type of impetigo usually requires oral antibiotics?
Bullous
What are the potential complications of impetigo?
- Cellulitis
- Lymphangitis
- Staphylococcal scaled skin syndrome
What complications may arise if the causative organism is group A beta haemolytic streptococcus?
- Scarlet fever
- Glomerulonephritis
