Impetigo

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CLINICAL DESCRIPTION

Bacterial infection affecting the uppermost layer of the epidermis (stratum corneum).

Risks factors:

  • Young age
  • Immunosuppression
  • Presence of underlying skin disease which compromise the integrity of the skin e.g., atopic dermatitis, tinea corporis, ulcers.

Cause

  • Staphylococcal aureus and Streptococcal pyogenes

CLINICAL FEATURESSIGNS AND SYMPTOMS

  • Blisters, vesicles, or pustules that break easily
  • Honey coloured/yellowish crusts
  • Skin erosions
  • Itch may or may not be present

INVESTIGATIONS

  • Diagnosis usually clinical
  • Pus Swab to confirm diagnosis where necessary or if not responsive to therapy

TREATMENT

General management

  • Keep infected areas clean:
  • wash daily with soap and clean water
  • Wash off crusts with clean water to expose clean raw base

Prevent spread to others                        -                

  • Frequently wash towels, beddings and clothes used and stained by the patient

Treatment

  • Localised/small area involved:
  • Fusidic acid 20mg/g cream 12 hourly for 7 days
  • Apply Gentian Violet paint 0.5 % after crusts have been removed from the affected area
  • treat underlying skin disease e.g., eczema or tinea if present to remove source of infection
  • If extensive give oral antibiotics
  • For children:
    • Flucloxacillin 12.5mg/kg body weight 6 hourly for 5-7 
  • Children if allergic to penicillin:
    • Give Erythromycin 125-500mg P.O 6 hourly for 5-7 days

Adults:

  • Flucloxacillin 500 mg P.O 6 hourly for 5 – 7 days
  • if allergic to penicillin, Erythromycin 500 mg P.O 6 hourly for 7 days