Impetigo

Last reviewed: 21 Apr 2022
Last updated: 07 Oct 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • vesicles/bullae
  • crusting
More key diagnostic factors

Other diagnostic factors

  • erythema
  • pruritus
  • pain
  • mucopurulent exudate
  • lymphadenopathy
  • fever
Other diagnostic factors

Risk factors

  • increased humidity
  • poor hygiene, malnutrition, and overcrowding
  • chronic colonisation with Staphylococcus aureus - nasal, axillary, pharyngeal, perineal
  • concomitant skin disease
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • bacterial skin culture
More investigations to consider

Treatment algorithm

ACUTE

neonates: non-bullous impetigo

neonates: bullous impetigo

adults, children, and infants: superficial or limited infection

adults, children, and infants: widespread cutaneous lesions

adults, children, and infants: deep soft tissue infection or haematogenous spread

Contributors

Authors

Michael Freeman, MB BS, FACD, FRACGP

Dermatologist

Associate Professor

Bond University

Queensland

Australia

Disclosures

MF declares that he has no competing interests.

Acknowledgements

Dr Michael Freeman would like to gratefully acknowledge Dr Chris Del Mar, a previous contributor to this topic.

Disclosures

CDM declares that he has no competing interests.

Peer reviewers

Brian Swick, MD

Clinical Assistant Professor

University of Iowa College of Medicine

Iowa City

IA

Disclosures

BS declares that he has no competing interests.

Julian Trevino, MD

Associate Professor of Dermatology and Dermatology Residency Program Director

Boonshoft School of Medicine

Wright State University

Dayton

OH

Disclosures

Speaker's Bureau, Stiefel; Consultant, Abbott.

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