Impetigo

Question 1

Impetigo Overview
A contagious, superficial, intraepidermal infection occurring prominently on exposed areas of the ______ and ________

Answer 1

face and extremities

Question 2

Primary vs Secondary impetigo
1. _______: Invasion at sites of minor trauma (abrasions, insect bites, underlying eczema)
2. _______: Invasion of previously normal skin
—–Can be considered to be S. aureus impetigo of hair follicles

Answer 2

1. Secondary
2. Primary

Question 3

What type of impetigo
Most common form of impetigo. Formation of vesiculopustules that rupture, leading to crusting with a characteristic golden appearance; local lymphadenopathy may occur.

Answer 3

Nonbullous impetigo

Question 4

What type of impetigo
A deeper, ulcerated impetigo infection often with lymphadenitis

Answer 4

Ecthyma

Question 5

What type of Impetigo
Staphylococcal impetigo that progresses from small to large flaccid bullae (newborns/young children) caused by epidermolytic toxin release; ruptured bullae leaving brown crust; less lymphadenopathy; trunk more often affected; <30% of patients.

Answer 5

Bullous impetigo

Question 6

What issue/Tx
A contagious, superficial, intraepidermal infection occurring prominently on exposed areas of the face and extremities
-Infected patients usually have multiple lesions.
-Satellite lesions appear beyond the periphery.

Answer 6

Impetigo
-Remove crusts; clean with gentle washing 2 to 3 times daily; and clean with antibacterial soap, chlorhexidine, or Betadine.
-Washing of entire body may prevent recurrence at distant sites.
Vanilla Staph:
(a) Nonbullous (minor spread, treat 7 days; widespread, treat 10 days); bullous (treat 10days)
(b) Mupirocin (Bactroban) 2% topical ointment applied TID for 5 to 7 days (nonbullous only)
(c) Dicloxacillin: Adult 250 mg PO QID
MRSA:
(a) Clindamycin, tetracyclines, or trimethoprim-sulfamethoxazole. Oral doses given for7 days are usually sufficient.
(b) Clindamycin 300 mg q6-8h
-Severe bullous disease may require IV therapy such as nafcillin or cefazolin.

Question 7

Prevent impetigo with _________ ointment TID to sites of minor skin trauma.

Answer 7

mupirocin

Question 8

Differential Diagnosis Impetigo

Answer 8

(1) Perioral dermatitis
(2 )Allergic contact dermatitis
(3) HSV-1/Herpes zoster
(4) Tinea infection

Question 9

Complications of impetigo

Answer 9

(1) Ecthyma
(2) Cellulitis
(3) Resistance to treatment
(4) Lymphangitis
(5) Furunculosis

Question 10

Primary vs Secondary impetigo
1. _______: Invasion at sites of minor trauma (abrasions, insect bites, underlying eczema)
2. _______: Invasion of previously normal skin

Answer 10

1. Secondary
2. Primary