IMPETIGO

Question 1

Causes of impetigo

Answer 1

• Break in skin
• Infection with S. aureus or Strep. Pyogenes
• Transmitted by: contact with infected individual/objects (contagious).

Question 2

Non bullous

Answer 2

• papules, vesicles, pustules
• rapidly break down
• form golden yellow crust

Question 3

Bullous

Answer 3

• Blisters that form crust (not yellow crusts)
• Swollen glands
• Fever
• Diarrhoea

Question 4

Treatment for Localised non-bullous:

Answer 4

1. FIRST:
   hydrogen peroxide 1% cream 2-3 times a day for 5-7 days (unsuitable around the eyes - would need topical abx)
2. SECOND: Fusidic Acid for 5 days
   mupirocin 2% if fusidic acid resistance suspected)

Question 5

Widespread non-bullous:

Answer 5

1. FIRST Fusidic Acid (Mupirocin 2% if fusidic acid resistance suspected)

Question 6

Bullous or patients who are systemically unwell:

Answer 6

1. Flucloxacillin 500mg QDS for 5 days
2. Clarithromycin 250mg BD for 5 days
   Pregnancy – Erythromycin 250-500mg QDS for 5 days