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