Medication
What is impetigo and is it treatable? Impetigo is a fairly common condition that affects mostly babies and children. It can be distressing because it is unsightly and quite contagious, but it is not serious and can usually be cleared up within a few days to a week with a course of antibiotics.
What is impetigo and is it treatable?
With treatment, impetigo is usually no longer contagious within 24 to 48 hours. Without treatment, impetigo often clears on its own in two to four weeks. During this time, there is a greater risk of developing complications. You may see new blisters and sores.
What is the prognosis of impetigo?
Impetigo starts as a red, itchy sore. As it heals, a crusty, yellow or “honey-colored” scab forms over the sore. In general, impetigo is a mild infection that can occur anywhere on the body. It most often affects exposed skin, such as around the nose and mouth or on the arms or legs.
What does impetigo look like in adults?
Bullous impetigo. The symptoms of bullous impetigo begin with the appearance of fluid-filled blisters (bullae) which usually occur on the trunk (the central part of the body between the waist and neck) or on the arms and legs. The blisters are usually about 1-2cm across.
What are the symptoms of bulbous impetigo?
How do you describe impetigo?
Impetigo (im-puh-TIE-go) is a common and highly contagious skin infection that mainly affects infants and young children. It usually appears as reddish sores on the face, especially around the nose and mouth and on the hands and feet. Over about a week, the sores burst and develop honey-colored crusts.
What does bullous impetigo look like?
Bullous impetigo is almost always caused by Staphylococcus aureus bacteria. It usually forms larger blisters, or bullae, filled with a clear fluid that may become darker and cloudy. The blisters start on unbroken skin and aren't surrounded by reddish areas. The blisters become limp and clear and then burst open.
How do you describe impetigo rash on a physical exam?
Characteristic findings on physical examination Impetigo is classified as bullous or nonbullous. In the latter form, which is seen most often, clinical findings include suprficial lesions with yellow-honey crusts (Figure 1). In the bullous type, bullae are evident on examination.
What does bullous impetigo mean?
Bullous impetigo is an acute blistering infection caused by Staphylococcus aureus group II, typically phage 71 infection. This strain of S. aureus carries exfoliative toxin A, which specifically targets and disrupts the intraepidermal keratinocyte connection desmoglein 1 (DSG1).
What is the difference between impetigo and bullous impetigo?
Impetigo primarily affects the skin or secondarily infects insect bites, eczema, or herpetic lesions. Bullous impetigo, which is caused exclusively by S. aureus, results in large, flaccid bullae and is more likely to affect intertriginous areas.
What is the difference between bullous and Nonbullous impetigo?
There are two types of impetigo: nonbullous (i.e., impetigo contagiosa) and bullous. Nonbullous impetigo represents a host response to the infection, whereas a staphylococcal toxin causes bullous impetigo and no host response is required to manifest clinical illness.
How do you treat bullous impetigo?
Impetigo is treated with prescription mupirocin antibiotic ointment or cream applied directly to the sores two to three times a day for five to 10 days.
How does bullous impetigo spread?
Impetigo can spread to anyone who touches infected skin or items that have been touched by infected skin (such as clothing, towels, and bed linens). It can be itchy, so kids also can spread the infection when they scratch it and then touch other parts of their body.
What is the most common complication of impetigo?
Complications of impetigo cellulitis – an infection of the deeper layers of the skin and underlying tissue. scarlet fever – a rare bacterial infection that causes a fine, pink rash across the body.
What causes a bulla?
Friction. One of the most common causes of bullae is friction. This includes the friction that occurs from using a shovel or another tool, or rubbing against the inside of a shoe. Friction blisters appear most often on your hands and feet.
What is the main cause of impetigo?
The main cause of impetigo is a bacterial infection. The bacteria usually enters the skin through a cut, scrape, rash or insect bite. Most of the time, the cause is the Staphylococcus aureus (“staph” bacteria). Sometimes, group A Streptococcus bacteria can cause it.
What are the different types of impetigo?
There are 3 kinds of impetigo:Nonbullous impetigo. This is the most common form in adults. It causes thick, honey-colored crusts.Bullous impetigo. This causes large blisters on the skin.Ecthyma. This is a more serious form that often results from untreated impetigo.
Does bullous impetigo go away on its own?
Untreated, impetigo often clears up on its own after a few days or weeks, Smith says. The key is to keep the infected area clean with soap and water and not to scratch it. The downside of not treating impetigo is that some people might develop more lesions that spread to other areas of their body.
How do you treat bullous impetigo?
Antibiotics treat impetigo Impetigo is treated with antibiotics that are either rubbed onto the sores (topical antibiotics) or taken by mouth (oral antibiotics). A doctor might recommend a topical ointment, such as mupirocin or retapamulin, for only a few sores. Oral antibiotics can be used when there are more sores.
Where do you get bullous impetigo?
Bullous impetigo is a bacterial skin infection caused by Staphylococcus aureus that results in the formation of large blisters called bullae, usually in areas with skin folds like the armpit, groin, between the fingers or toes, beneath the breast, and between the buttocks.
What does impetigo look like on adults?
Impetigo causes red bumps to form on your skin, often on your face, arms, or legs. These bumps then become blisters. These blisters burst and scab over, forming a yellow-brown crust. The skin may also look reddish or raw where the blisters have popped open.
What causes bullae in children?
The bullae are caused by exfoliative toxins produced by Staphylococcus aureus that cause the connections between cells in the uppermost layer of the skin to fall apart . Bullous impetigo in newborns, children, or adults who are immunocompromised and/or are experiencing kidney failure, can develop into a more severe and generalized form called ...
What is bullous impetigo?
Bullous impetigo is a bacterial skin infection caused by Staphylococcus aureus that results in the formation of large blisters called bullae , usually in areas with skin folds like the armpit, groin, between the fingers or toes, beneath the breast, and between the buttocks.
What is the name of the blister on the side of the swollen glands?
Vesicles rapidly enlarge and form the bullae which is a blister more than 5mm across. Bullae is also known as staphylococcal scalded skin syndrome. Other associated symptoms are itching, swelling of nearby glands, fever and diarrhea. Pain is very rare.
What is the function of exfoliating toxins?
Pathogenesis. Exfoliating toxins are serine proteases that specifically bind to and cleave desmoglein 1 (Dsg1). Previous studies suggested that exfoliating toxins bind to gangliosides, causing a release of protease by keratinocytes acting as superantigens in stimulating the skin's immune system.
Where is the cleavage plane of bullous impetigo?
H&E of Bullous Impetigo. The cleavage plane can be found either subcorneally or within the upper stratum granulosum. The roof of the pustule is parakeratotic stratum corneum, and the floor is formed of keratinocytes, which may or may not be acantholytic. Neutrophils begin to fill the pustule.
Where does bullous impetigo occur?
Bullous impetigo can appear around the diaper region, axilla, or neck. The bacteria causes a toxin to be produced that reduces cell-to-cell stickiness (adhesion), causing for the top layer of skin (epidermis), and lower layer of skin (dermis) to separate. Vesicles rapidly enlarge and form the bullae which is a blister more than 5mm across. Bullae is also known as staphylococcal scalded skin syndrome. Other associated symptoms are itching, swelling of nearby glands, fever and diarrhea. Pain is very rare.
How to prevent impetigo in children?
Since the common pathogens involved with impetigo are bacteria naturally found on the skin, most prevention (especially in children), is targeted towards appropriate hygiene, wound cleaning, and minimizing scratching (i.e. by keeping nails trimmed and short). Avoiding close contact and sharing of items such as towels with potentially infected individuals is also recommended.
What does it mean when your nose is red?
It most often affects exposed skin, such as around the nose and mouth or on the arms or legs. Symptoms include red, itchy sores that break open and leak a clear fluid or pus for a few days. Next, a crusty yellow or “honey-colored” scab forms over the sore, which then heals without leaving a scar.
Why do you have to cover impetigo sores?
Keep sores caused by impetigo covered in order to help prevent spreading group A strep to others. If you have scabies, treating that infection will also help prevent impetigo.
What does impetigo look like?
Impetigo starts as a red, itchy sore. As it heals, a crusty, yellow or “honey-colored” scab forms over the sore.
How to keep impetigo from spreading?
These items should not be shared with anyone else. After they have been washed, these items are safe for others to use. The best way to keep from getting or spreading group A strep is to wash your hands often .
How to diagnose impetigo?
Doctors typically diagnose impetigo by looking at the sores (physical examination). Lab tests are not needed.
Why do doctors prescribe antibiotics for impetigo?
Doctors use antibiotics to treat impetigo and prevent rare, but serious long-term health problems. Antibiotics can also help protect others from getting sick.
What is the most common risk factor for impetigo?
Close contact or crowding: Close contact with another person with impetigo is the most common risk factor for illness. For example, if someone has impetigo, it often spreads to other people in their household. Infectious illnesses also tend to spread wherever large groups of people gather together.
What is Impetigo caused by?
Impetigo can be caused by Streptococcus pyogenes and Staphylococcus aureus. This page focuses on infections caused by S. pyogenes, which are also called group A Streptococcus or group A strep.
How is streptococcal impetigo spread?
Streptococcal impetigo is most commonly spread through direct contact with other people with impetigo. People with impetigo are much more likely to transmit the bacteria than asymptomatic carriers. Crowding, such as found in schools and daycare centers, increases the risk of disease spread from person to person.
How to diagnose impetigo?
Impetigo is usually diagnosed by physical examination, but physical examination cannot reliably differentiate between streptococcal and staphylococcal non-bullous impetigo. 1 Gram stain or culture of the exudate or pus from an impetigo lesion can identify the bacterial cause. However, laboratory testing is not necessary nor routinely performed in clinical practice.
What antibiotics are used for impetigo?
Antibiotic treatment, whether oral or topical, should be aimed at both bacteria that are associated with impetigo: group A strep and S. aureus. Topical antibiotics, mupirocin or retapamulin, may be used when there are only a few lesions, while oral antibiotics are used for multiple lesions. 1,2,3
How to prevent impetigo?
The spread of impetigo can be prevented by covering lesions, treating with antibiotics, and practicing good hand hygiene. Clothing, linens, and towels used by an infected person should be washed every day and not shared with others in the household.
How long does it take for impetigo to develop?
The incubation period of impetigo, from colonization of the skin to development of the characteristic lesions, is about 10 days. 1 It is important to note not everyone who becomes colonized will go on to develop impetigo.
What age group is most likely to get impetigo?
Risk Factors. Impetigo can occur in people of all ages, but it is most common among children 2 through 5 years of age. Scabies infections and activities that result in cutaneous cuts or abrasions (e.g., sports such as wrestling and football) increase the risk of impetigo.
How long does it take for a bullous pemphigoid to go away?
Bullous pemphigoid usually goes away within 5 years, and generally responds well to treatment. However, blisters that rupture and become infected can lead to a life-threatening condition called sepsis. For this reason, it is important to seek treatment at your first sign of symptoms.
What is bullous pemphigoid?
Bullous pemphigoid is a rare autoimmune skin disorder that usually, but not always, affects people who are 60 years old or older. It might present with blisters or welts seen on arms, legs, groin, mouth or abdomen. Treatment involves corticosteroids. Appointments 216.444.5725.
Where do bullous pemphigoid blisters occur?
Bullous pemphigoid may affect a small area of the body or be widespread. The blisters usually occur on areas of the skin that are flexible, such as under the armpit or on the abdomen. About one-third of people with bullous pemphigoid develop blisters in their mouth, throat, and esophagus, in addition to their skin.
Where are the blisters on my pemphigoid?
The skin around the blisters can appear either normal or red. The blisters are usually located along creases in the skin. You should seek medical attention from your healthcare provider if you think you might have bullous pemphigoid.
Is bullous pemphigoid common in the Far East?
Bullous pemphigoid occurs most often in people over age 60, but it can appear in younger individuals as well. It is seen more in the Western world; it is not common in the Far East. Both men and women are affected equally by bullous pemphigoid.
How long does it take for impetigo to spread?
Over about a week, the sores burst and develop honey-colored crusts. Treatment with antibiotics can limit the spread of impetigo to others. Keep children home from school or day care until they're no longer contagious — usually 24 hours after beginning antibiotic treatment.
What causes blisters on the trunk of the arms and legs?
Bullous impetigo causes fluid-filled blisters — often on the trunk, arms and legs of infants and children younger than 2 years.
How to prevent impetigo from spreading?
To help prevent impetigo from spreading to others: Gently wash the affected areas with mild soap and running water and then cover lightly with gauze. Wash an infected person's clothes, linens and towels every day with hot water and don't share them with anyone else in your family.
What is the name of the sore that oozes for a few days and then forms a honey-?
Overview. Impetigo starts as a reddish sore that ruptures, oozes for a few days and then forms a honey-colored crust. Sores mainly occur around the nose and mouth in infants and children. Impetigo (im-puh-TIE-go) is a common and highly contagious skin infection that mainly affects infants and young children.
How long can you keep a child with impetigo?
Keep your child with impetigo home until your doctor says they aren't contagious.
How to keep a child from getting impetigo?
Cut an infected child's nails short to prevent damage from scratching. Encourage regular and thorough handwashing and good hygiene in general. Keep your child with impetigo home until your doctor says they aren't contagious.
When does impetigo occur?
Impetigo occurs most commonly in children ages 2 to 5. Close contact. Impetigo spreads easily within families, in crowded settings, such as schools and child care facilities, and from participating in sports that involve skin-to-skin contact. Warm, humid weather.
What age group is bullous pemphigoid most commonly found in?
Bullous pemphigoid most commonly occurs in older adults, and the risk increases with age.
What medications cause bullous pemphigoid?
Prescription drugs that may cause bullous pemphigoid include etanercept (Enbrel), sulfasalazine (Azulfidine), furosemide (Lasix) and penicillin. Light and radiation.
How long does it take for bullous pemphigoid to go away?
Bullous pemphigoid often goes away on its own in a few months, but may take as many as five years to resolve. Treatment usually helps heal the blisters and ease any itching. It may include corticosteroid medications, such as prednisone, and other drugs that suppress the immune system.
Why do older people have bullous pemphigoid?
Bullous pemphigoid is most common in older adults. Bullous pemphigoid occurs when your immune system attacks a thin layer of tissue below your outer layer of skin. The reason for this abnormal immune response is unknown, although it sometimes can be triggered by taking certain medications.
What is a blister that ruptures?
When the blisters rupture, they leave a sore that typically heals without scarring. Bullous pemphigoid (BUL-us PEM-fih-goid) is a rare skin condition that causes large, fluid-filled blisters. They develop on areas of skin that often flex — such as the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in older adults.
What does it mean when you have a blister on your face?
Large blisters that don't easily rupture when touched, often along creases or folds in the skin. Skin around the blisters that is normal, reddish or darker than normal. Eczema or a hive-like rash. Small blisters or sores in the mouth or other mucous membranes (benign mucous membrane pemphigoid)
What causes blisters on the skin?
These antibodies trigger inflammation that produces the blisters and itching of bullous pemphigoid.
What is impetigo caused by?
Impetigo is an infection caused by strains of staph or strep bacteria. These bacteria can get into your body through a break in the skin from a cut, scratch, insect bite, or rash. Then they can invade and colonize.
How many types of impetigo are there?
There are three types of impetigo based on the bacteria that cause them and the sores they form. Each type goes through a series of stages.
What is the best treatment for impetigo?
If you have impetigo in only a small area of your skin, topical antibiotics are the preferred treatment. Options include mupirocin cream or ointment (Bactroban or Centany) and retapamulin ointment (Altabax).
What are the symptoms of impetigo?
The symptoms of impetigo in adults are sores around the nose and mouth or other exposed areas of the body that break open, ooze, and then crust.
Why is impetigo called the school disease?
Because it spreads so easily, impetigo is sometimes called the school disease. It can quickly spread from child to child in a classroom or day care center where children are in close contact. For the same reason, it also spreads easily in families.
What age group is most likely to develop impetigo?
Toddlers are the most likely age group to develop impetigo. The infection looks different on young children than it does on adults. Parents may see sores around their child’s nose and mouth, as well as on the trunk, hands, feet, and in the diaper area.
What is the term for a blister on the bottom of the diaper?
These fluid-filled blisters soon burst, leaving a scaly rim called a collarette .
How to spread impetigo?
And you can infect others. “To spread impetigo, you need fairly close contact — not casual contact — with the infected person or the objects they touched,” he says. Avoid spreading impetigo to other people or other parts of your body by: 1 Cleaning the infected areas with soap and water. 2 Loosely covering scabs and sores until they heal. 3 Gently removing crusty scabs. 4 Washing your hands with soap and water after touching infected areas or infected persons.
What is the most common childhood disease?
Impetigo — one of the most common childhood diseases — can be treated with medications approved by the U.S. Food and Drug Administration (FDA). Impetigo is a common bacterial skin infection that can produce blisters or sores anywhere on the body, but usually on the face (around the nose and mouth), neck, hands, and diaper area.
How long does it take for impetigo to clear up?
Untreated, impetigo often clears up on its own after a few days or weeks, Smith says. The key is to keep the infected area clean with soap and water and not to scratch it. The downside of not treating impetigo is that some people might develop more lesions that spread to other areas of their body.
What causes impetigo on the skin?
What Causes Impetigo. Two types of bacteria found on our skin cause impetigo: Staphylococcus aureus and Streptococcus pyogenes (which also causes strep throat). Most of us go about our lives carrying around these bacteria without a problem, Smith says.
How many people get impetigo every year?
Although impetigo is a year-round disease, it occurs most often during the warm weather months. There are more than 3 million cases of impetigo in the United States every year.
What is the best treatment for impetigo?
Impetigo is usually treated with topical or oral antibiotics. If you have multiple lesions or if there is an outbreak, your doctor might prescribe an oral antibiotic. There is no over-the-counter (OTC) treatment for impetigo.
Can you spread impetigo to others?
And you can infect others. “To spread impetigo, you need fairly close contact — not casual contact — with the infected person or the objects they touched,” he says. Avoid spreading impetigo to other people or other parts of your body by:
Overview
Signs and symptoms
Cause
Pathogenesis
Specialist to consult
Diagnosis
Bullous impetigo is a bacterial skin infection caused by Staphylococcus aureus that results in the formation of large blisters called bullae, usually in areas with skin folds like the armpit, groin, between the fingers or toes, beneath the breast, and between the buttocks. It accounts for 30% of cases of impetigo, the other 70% being non-bullous impetigo.
The bullae are caused by exfoliative toxins produced by Staphylococcus aureus that cause the c…
Prevention
Bullous impetigo can appear around the diaper region, axilla, or neck. The bacteria causes a toxin to be produced that reduces cell-to-cell stickiness (adhesion), causing for the top layer of skin (epidermis), and lower layer of skin (dermis) to separate. Vesicles rapidly enlarge and form the bullae which is a blister more than 5mm across. Bullae is also known as staphylococcal scalded skin syndrome. Other associated symptoms are itching, swelling of nearby glands, fever and dia…
Management
Exposure is most commonly seen in hospital wards and nurseries, and can be passed from person to person in other settings, such as close contact sports. Therefore, the patient is advised to try to limit human contact as much as possible to minimize the risk of spreading the infection.
After 48 hours the disease is considered no longer contagious assuming the proper antibiotic treatments have been administered.
See also
Exfoliating toxins are serine proteases that specifically bind to and cleave desmoglein 1 (Dsg1). Previous studies suggested that exfoliating toxins bind to gangliosides, causing a release of protease by keratinocytes acting as superantigens in stimulating the skin's immune system. A more recent proposal states there are three known exfoliating toxins; ETA, ETB, and ETD which act as a glutamic acid-specific serine protease with concentrated specificity. Which results in the cleav…
Etiology
Observing the skin's physical appearance, or swabbing a culture of the lesion for S. aureus. Nasal swabs from the patient's immediate family members are necessary to identify them as being asymptomatic nasal carriers of S. aureus.
The epidermis is composed of four layers, stratum basale, stratum spinosum, stratum granulosum, and stratum corneum.
Clinical Features
Since the common pathogens involved with impetigo are bacteria naturally found on the skin, most prevention (especially in children), is targeted towards appropriate hygiene, wound cleaning, and minimizing scratching (i.e. by keeping nails trimmed and short). Avoiding close contact and sharing of items such as towels with potentially infected individuals is also recommended.
Transmission
Antibiotic creams are the preferred treatment for mild cases of impetigo, despite their limited systemic absorption. Such prescribed ointments include neosporin, fusidic acid, chloramphenicol and mupirocin. More severe cases of impetigo however (especially bullous impetigo) will likely require oral agents with better systemic bioavailability, such as cephalexin. Cases that do not resolve with initial antibiotic therapy or require hospitalization may also be indicative an MRSA in…
Incubation Period
• Impetigo contagiosa
• Skin lesion
• List of conditions caused by problems with junctional proteins
Risk Factors
- Impetigo can be bullous or non-bullous. Toxin-producing S. aureus cause bullous impetigo. S. aureus, S. pyogenes, or both cause non-bullous impetigo, which is also called “impetigo contagiosa.” S. pyogenes are gram-positive cocci that grow in chains (see Figure 1). They exhibit β-hemolysis (complete hemolysis) when grown on blood agar plates. They ...
Diagnosis and Testing
- Streptococcal impetigo, or non-bullous impetigo, begins as papules. The papules evolve to pustules and then break down to form thick, adherent crusty lesions (Figure 2). The crusts are typically golden or “honey-colored.” These lesions usually appear on exposed areas of the body, most commonly the face and extremities, but can occur anywhere on the body. Multiple lesions t…
Treatment
- Streptococcal impetigo is most commonly spread through direct contact with other people with impetigo, including through contact with drainage from impetigo lesions. Lesions can be spread (by fingers and clothing) to other parts of the body. People with impetigo are much more likely to transmit the bacteria than asymptomatic carriers. Crowding, such as found in schools and dayca…
Prognosis and Complications
- The incubation period of impetigo, from colonization of the skin to development of the characteristic lesions, is about 10 days.1 It is important to note not everyone who becomes colonized will go on to develop impetigo.
Prevention
- Impetigo can occur in people of all ages, but it is most common among children 2 through 5 years of age. Scabies infections and activities that result in cutaneous cuts or abrasions increase the risk of impetigo. Poor personal hygiene, including lack of proper hand, face, or body hygiene, can increase someone’s risk of impetigo. Impetigo can occur in any climate and at any time of year, …
Epidemiology
- Impetigo is diagnosed by physical examination, but physical examination cannot reliably differentiate between streptococcal and staphylococcal non-bullous impetigo.1Gram stain or culture of the exudate or pus from an impetigo lesion can identify the bacterial cause; however, laboratory testing is not necessary nor routinely performed in clinical practice.