RTS - MC, Impetigo, Chickenpox

Question 1

What causes impetigo?

Answer 1

bacterial infection

• staphylococcus pyogenes
• staphylococcus aureus

Question 2

What are the types of impetigo and their causes?

Answer 2

non-bullous impetigo - 1, 2 or both 
- red sores
- sores breaks open and leave the skin red and inflamed 
bullous impetigo - staphylococcus aureus
- large blisters or bullae
- burst and leave a honey coloured crust

Question 3

Is impetigo contagious?

Answer 3

highly contagious

- spread by direct contact

Question 4

What are the symptoms of impetigo?

Answer 4

small, itchy red patch of skin that becomes inflamed
rash develops into vesicles ( blisters filled with fluid and pus)
blisters weep and burst leaving a honey coloured crust

Question 5

How is impetigo spread on the body and where does it start?

Answer 5

it is usually found on the mouth, nose and chin

it can be spread to other parts of the body

Question 6

What is the treatment for impetigo?

Answer 6

prescription only - must refer
topical or oral antibiotic treatment for bacterial infection

topical - fusidic acid = cream or ointment
oral - flucloxillin or penicillin
if allergic to penicillin then clarithromycin can be taken

Question 7

What are the practical measures for impetigo?

Answer 7

keep nails short to prevent scratching
avoid sharing towels, clothes, etc

wash hands regularly especially after touching a patch of impetigo
wash the affected areas with water and soap

no OTC

Question 8

When is it suitable for people with impetigo to freely socialise?

Answer 8

patient should stay home until the lesions are healed, dry and crusted or until 48 hours after the antibiotic treatment begins

Question 9

What causes molluscum contagiosum?

Answer 9

viral infection

-pox virus

Question 10

What are the symptoms of molluscum contagiosum?

Answer 10

pinkish or pearly white wart-like lumps/papules
have a central punctum - dimple
- punctum is diagnostic
white cheesy exudate is seen upon squeezing

can be itchy, smooth and firm

Question 11

Where does molluscum contagiosum start on the body?

Answer 11

commonly found on the face and axillae (arm pit)

• possibly on eyelids and trunk
• rarely on the hands and soles

Question 12

What is the treatment for molluscum contagiosum?

Answer 12

no cure
best left untreated
- will resolve itself within 18 months
- only possibly of being problematic in people with HIV. or immunosuppression

Question 13

What are practical measures for molluscum contagiosum?

Answer 13

avoid squeezing the mollusca to avoid spread of the virus
avoid sharing towels, clothes and baths
cut nails to avoid scratching

can suggest OTC for itching

• aqueous cream
• eurax cream

Question 14

When is it suitable for people with molluscum contagiosum to freely socialise?

Answer 14

patients do not need to stay home
- exclusion from school, gym or swimming is not necessary

avoid contact

Question 15

Is molluscum contagiosum contagious?

Answer 15

highly contagious

- commonly found in children and infants

Question 16

What causes chickenpox?

Answer 16

viral infection

- varicella zoster virus

Question 17

Is chickenpox contagious?

Answer 17

contagious/infectious

• until spots crust over
• common in children

Question 18

What is the incubation, infection and rash period of chickenpox?

Answer 18

incubation period - 11-21 days = time between contact and development of rash
infectious period - 5-6 days after rash appears
rash period - infection is typically over within a week but exclusion is not necessary 6 days after rash onset

Question 19

What are the symptoms of chicken pox?

Answer 19

preceded by flu-like symptoms
- fever, headache, sore throat
rash appears
- appears on the face and trunk then are able to spread
- may involve the mucous membranes of the mouth
- small red spots/lumps develop into blisters (vesicles) that burst forming crusted spots

come out in crops over 5 days

Question 20

What is the treatment for chickenpox?

Answer 20

no cure

symptomatic treatment only

Question 21

What are practical measures for chickenpox?

Answer 21

cut nails short to avoid scratching
drink lots of water/ fluids to stay hydrated
dress in loose clothing

aqueous cream for itching - eurax, crotamiton, aloe vera
antihistamine - chlorphenamine,
paracetamol for pain relief, fever and headache

Question 22

When is it suitable for people with chickenpox to freely socialise?

Answer 22

staying home is not necessary after 6 days from the onset of the rash