Impetigo

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Impetigo is a highly contagious superficial bacterial skin infection. It is common in neonates and children and may be associated with conditions such as scabies, eczema, lice infestation and herpes simplex infection as secondary infection. The condition does not cause any symptoms until four to 10 days after initial exposure. It usually improves within a week of treatment. 

There are two types of impetigo. The non-bullous type typically affects the skin around the nose and mouth, causing lesions to develop, that quickly burst to leave a yellow-brown crust. The other type, bullous  impetigo, typically affects the trunk causing fluid-filled blisters (bullae) to develop that burst after a few days to leave a yellow crust.

Both types of impetigo may leave behind marks when the crusts have cleared up, but these usually improve over the following days or weeks.

Its prevention involves good hygiene, regular hand-washing, trimming of fingernails to reduce breaking of the skin through scratching, and discouraging the sharing of towels and clothing.

Cause

• Staphylococcus aureus 
• Streptococcus pyogenes

Symptoms

• Pus-filled blisters and sores on the body or scalp

Signs

• Superficial, fragile fluid-filled blisters
• Irregular spreading ulcers with yellow crusts

Investigations

• Often no test required 
• Microscopy and culture of the exudate from the blisters (except in recurrent or severe cases)

TreatmentTreatment Objectives

• To eradicate infection
• To prevent transmission
• To  reduce the risk of developing complications (e.g.cellulitis, septicaemia)
• To identify and treat any predisposing condition

Non-pharmacological treatment

• Antiseptic baths for all cases

Pharmacological treatment 

See sections below

Referral Criteria

Refer for hospital care and treatment if spreading rapidly or cellulitis, osteomyelitis or septicaemia develops.