Common bacterial infection of the skin (usually staphylococcal or streptococcal) that typically occurs in children.
Highly contagious, which is a key consideration for schools and playgroups.
Skin that has been broken by minor trauma or other disease is particularly susceptible to infection.
Usually resolves spontaneously or with topical antiseptics.
Topical antibiotics (such as mupirocin or fusidic acid) are effective, but resistance may be a problem in some places.
Systemic antibiotics may be necessary; for example, if infection is recalcitrant to topical treatment, if there is concern about complications (e.g., acute rheumatic fever), or if deeper infection is suspected.
Impetigo is a superficial, contagious, blistering infection of the skin caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes . It has 2 forms: nonbullous and bullous. Bullae are fluid-filled lesions >0.5 cm in diameter.
Nonbullous impetigo is the more common form (70% of cases).  Though bullae are not present in this form, vesicles (fluid-filled lesions <0.5 cm in diameter) may appear transiently early in the disease. Etiologic agents are Staphylococcus aureus , Streptococcus pyogenes , or a combination of the 2 organisms. Lesions occur at sites of skin trauma.
Bullous impetigo is due to Staphylococcus aureus skin infection. Lesions occur on intact skin.
MF declares that he has no competing interests.
Dr Michael Freeman would like to gratefully acknowledge Dr Chris Del Mar, a previous contributor to this monograph. CDM declares that he has no competing interests.
Clinical Assistant Professor
University of Iowa College of Medicine
BS declares that he has no competing interests.
Associate Professor of Dermatology and Dermatology Residency Program Director
Boonshoft School of Medicine
Wright State University
Speaker's Bureau, Stiefel; Consultant, Abbott.
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