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Impetigo

Last reviewed: 30 Sep 2024
Last updated: 27 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • vesicles/bullae
  • crusting
Full details

Other diagnostic factors

  • erythema
  • pruritus
  • pain
  • mucopurulent exudate
  • lymphadenopathy
  • fever
Full details

Risk factors

  • increased humidity
  • poor hygiene, malnutrition, and overcrowding
  • chronic colonization with Staphylococcus aureus - nasal, axillary, pharyngeal, perineal
  • concomitant skin disease
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • bacterial skin culture
Full details

Treatment algorithm

ACUTE

neonates: nonbullous 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 hematogenous 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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