Impetigo

Impetigo is a highly contagious and common bacterial infection of the skin that typically occurs in children; a key consideration for schools and playgroups.

Typically staphylococcal or streptococcal. Diagnosis is usually clinical; bacterial skin cultures are reserved for extensive disease or where there is risk of spread of infection.

Skin that has been broken by minor trauma or other disease is particularly susceptible to infection.

Tends to resolve spontaneously or with topical antiseptics.

Topical antibiotics are effective, but resistance may be an issue in some regions.

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 two forms: nonbullous and bullous. Bullae are fluid-filled lesions >0.5 cm in diameter.

Nonbullous impetigo is the more common form (70% of cases).[1]Hartman-Adams H, Banvard C, Juckett G. Impetigo: diagnosis and treatment. Am Fam Physician. 2014 Aug 15;90(4):229-35. https://www.aafp.org/afp/2014/0815/p229.html http://www.ncbi.nlm.nih.gov/pubmed/25250996?tool=bestpractice.com 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.[1]Hartman-Adams H, Banvard C, Juckett G. Impetigo: diagnosis and treatment. Am Fam Physician. 2014 Aug 15;90(4):229-35. https://www.aafp.org/afp/2014/0815/p229.html http://www.ncbi.nlm.nih.gov/pubmed/25250996?tool=bestpractice.com ​ Lesions occur on intact skin.