Impetigo

Question 1

what is impetigo

Answer 1

a common superficial bacterial infection of the skin. commonly caused by staphylococcus aureus or streptococcus pyogens.

can be bullous or non bullous
*non bullous is most common and recognisable- typical, crusted honey coloured lesion

Question 2

presentation of non bullous impetigo

Answer 2

usually caused by bacteria (staph aurues / strep pyogens) entering the skin through a site of minor trauma.

small fluid filled vesicles / pustules
progresses over hrs / days to honey coloured ctrusted lesions
face / hands / mouth / chin

Question 3

presentation of bullous impetigo

Answer 3

caused by a staphylococcus bacteria which invades INTACT skin and damage the superficial epidermis and causes blisters / bullae

small fluid filled vesicles
continues to progress into large fluid filled blisters/bullae which rupture easily
can be painful
pt generally unwell

Question 4

diagnosis of impetigo

Answer 4

bedside- clinical diagnosis
swabs- if extensive area, lesions don’t respond to tx, MRSA suspected

Question 5

management of impetigo

Answer 5

conservative:
hygiene advise- regular hand washing, avoid touching, do not share towels.
school/work- don’t attend until lesions have crusted over or 48’ of oral abx

medical:
2’ care if signs of immunocompromise / complications

non bullous impetigo
5/7 hydrogen peroxide 1% cream
topical abx if widespread i.e fusidic acid 2% or mupirocin 2%
if systemically unwell- flucloxacillin

bullous impetigo
flucloxacillin
consider ref to derm

Question 6

complications of impetigo

Answer 6

superadded infection
- cellulitis
- sepsis
- if group a beta haemolytic streptococcus caused the impetigo this can develop to scarlet fever or glomerulonephritis (rare)