Impetigo

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Is  a  contagious  primary  infection  of  the  skin  involving  the  stratum  corneum  of  epidermis.  It  is  particularly common in children and people in disadvantaged areas.   

Clinical presentation 

• Polycyclic vesicles or blisters, which can contain pus 
• Early lesions are isolated or confluent erosions and yellowish crusts (“honey-colored”) 

Note: Impetigo is a clinical diagnosis and the typical location in children is around orifices, especially  the mouth and nose. 

Non-pharmacological Treatment 

• Improve personal hygiene 
• Hand washing 
• Wash lesions with soap and water 
• Remove crust 

Pharmacological Treatments   

A:  Wet  dressing  with  weak  potassium  permanganate  (PP)  soaks,  1:40000  (0.025%) solution 12hourly for 3–4days. Each session to last for 15 to 20minutes 

A: gentian violet paint (topical) 0.5% 12hourly for 5days 

OR 

C: mupirocin (topical) 2% 12hourly for 5–7days  

OR 

C: fusidic acid (topical) 12hourly for 5–7days 

If severe or systemic symptoms are present (e.g. pyrexia) add an oral antibiotic: 

A: phenoxymethylpenicillin (PO): Adult 500mg; paediatric 25mg/kg given 6hourly for 7days 

OR 

A: erythromycin (PO): Adult 500mg; paediatric 25-50mg/kg 8hourly for 10days 

OR 

B: amoxicillin + clavulanic acid 625mg (PO) 8hourly for 5days