Impetigo

Impetigo is a skin infection caused by bacteria and is more common in children suffering from eczema (atopic dermatitis) between the ages of 2 and 6 years. It is caused by bacterial entry into broken skin such as cuts, insect bites, or wounds.

Impetigo is of two forms non bullous and bullous.

Nonbullous impetigo is an infection of the upper layer of the skin and is common in children. Bullous impetigo is a toxin-mediated skin condition in which the top layer of skin sheds, leading to large areas of skin loss.

In nonbullous impetigo, symptoms start with red pimple-like lesions that turn into vesicle or pus filled sores. The vesicles break down leaving a yellow crusted appearance. These sores can occur anywhere on your body, but most commonly occur on the face, especially around the corners of the mouth, the nose and back of the ears, as well as the arms and legs. In bullous impetigo small or large, fragile, bullae appear that break open and leave the remnants at the site of infection. Patients with this form of impetigo often suffer from fever, loose stools and weakness in addition to the skin rash. Itching is a common symptom. Lymph nodes of the area may become swollen.

Impetigo is most commonly caused by Staphylococcus bacteria, but it can also be caused by group A Streptococcus bacteria. The bacteria enter the body through damaged skin. Other common causes include atopic disease and extreme changes in temperature such as warm and humid temperature.

The infection spreads from one person to another by direct contact with an infected wound or by contact with wound discharge from an infected person.

Your doctor will gather a complete medical history and perform an examination of the skin lesion to make a diagnosis of impetigo. A culture of the skin or lesion is usually recommended to confirm the type of bacteria present in the lesion.

Topical mupirocin (Bactroban®) or retapamulin (Altabax®) for a 5 day course is a recommended treatment for nonbullous impetigo.

Oral antibiotics are recommended in extensive involvement or for bullous impetigo. Some of the antibiotics recommended include cephalexin (Keflex®), erythromycin (Ery-Tab®), dicloxacillin (Dycill®) and clindamycin (Cleocin®).

You can prevent impetigo by following these tips:

Avoid contact with other people having impetigo.

Keep your skin clean and dry.

Avoid scratching insect bites and injuring your skin.

Clean minor wounds with antiseptic soap and clean water.

Cut your child’s nails short and encourage them not to scratch their scabs, pick their nose, bite their nails or suck their fingers.