impetigo Flashcards
definition of impetigo
common, superficial, highly contangeous bacterial skin infection
classified into bullous and non-bullous
organism in impetigo
staph aureus and strep pyogenes (gp A beta haemolytic strep)
what is ecthyma
deep form of impetigo causing deeper erosions of skin
presentation of non-bullous impetigo
Begins with a single erythematous macule which evolves into a pustule or vesicle.
Pustule or vesicle ruptures releasing serous contents which dries leaving a typical honey-coloured crust.
Minimal or no surrounding erythema.
Can spread rapidly with satellite lesions due to autoinoculation.
“Kissing lesions” arise where two skin surfaces are in contact.
Patients are typically well; some itching and regional lymphadenopathy.
presentation of bullous impetigo
Can spread distally due to autoinoculation.
Present as quickly appearing superficial, small or large thin roofed bullae which tend to spontaneously rupture and ooze yellow fluid leaving a scaley rim (collarette).
More likely to have systemic symptoms of malaise, fever, and lymphadenopathy.
Rfs for impetigo
Skin conditions: atopic dermatitis, contact dermatitis, scabies, chickenpox
Skin trauma: lacerations, insect bites, thermal burns, abrasions
Immunosuppression
Warm, humid climate
Poor hygiene
Crowded environments.
organism behind impetigo
staph aureus
less so strep pyogenes
complication of impetigo
Wider spread infection: cellulitis, lymphangitis, and bacteraemia.
Staphylococcal scalded skin syndrome.
Scarlet fever.
Post-streptococcal glomerulonephritis
Streptococcal toxic shock syndrome
Postinflammatory pigmentation.
Scarring, particularly with ecthyma.
dx of impetigo
clinical
skin swab
nose swab in recurrent
mx of impetigo
gentle cleaning
good hygeine
cover areas with water tight dressing - prevent spread
1. hydrogen peroxide cream - non-bullous, localised
2. fusidic acid
3. oral fluclox
