What is Impetigo and Who is at Risk?

Impetigo is a common skin infection seen mostly among school-going children. This contagious condition manifests in the form of blisters on the face, neck, hands and the diaper area.

What Is Impetigo?

Impetigo is a superficial skin infection caused by Staphylococcus aureus, Streptococcus pyogenes or methicillin-resistant Staphylococcus aureus (MRSA). A child’s skin that is already irritated by other skin problems, such as eczema, poison ivy, insect bites and cuts or scrapes stands a higher risk of developing impetigo.

Studies show that cases of impetigo are more common in tropical climates and in areas lying in lower altitudes. Humid conditions and poor hygiene may promote its occurrence. Research also shows that people of all races can be affected by impetigo and it is more common in boys. Even though it can impact people of all ages, the most common occurrences are among children.

Causes and Symptoms of Impetigo

The skin has many types of bacteria on it and these bacteria can enter the body through cracks on the skin, caused by animal or insect bites and injuries, grow there and cause infections and inflammation. A healthy epidermis may also develop impetigo.

There are two types of impetigo:

  • Non-bullous impetigo (crusted):

This is the more common form of impetigo that may be caused by both staphylococcus and streptococcus bacteria. This form initially presents itself as small red papules that evolve rapidly into small blisters. These blisters finally turn into scabs with a characteristic honey-colored crust that is usually seen around the nose and on the face but can affect the arms and legs too.

  • Bullous impetigo (large blisters):

This condition is caused only by the staphylococcus bacteria. The bacteria produce a toxin that reduces cell-to-cell adhesion causing a separation of the epidermis (top layer of the skin) from the dermis (lower layer of the skin). This leads to the formation of blisters in various areas, especially the torso and buttocks. These blisters contain a clear yellow fluid and are fragile. A dark crust develops in the final stages and usually disappears as the blisters heal. This condition is most common in newborns and infants, and 90 percent of children diagnosed with the condition are under 2 years old.

The most common symptoms associated with the condition are:

  • Blisters filled with pus (ruptured blisters can leave a reddish mark in infants)
  • Blisters that itch:
    • Have yellow or honey-colored fluid
    • Oozing occurs with crusting
  • Rashes that begin at a single spot but spread with itching
  • Rashes or sores on the face, lips, arms or legs
  • Swollen lymph nodes near the infected areas

What is Impetigo and Who is at Risk?

Diagnosis and Treatment of Impetigo

The diagnosis of impetigo is usually based on the appearance of the blisters or rashes and can be easily identified with visual inspection. If required, doctors may run a sample of the bacteria to determine if MRSA is involved because MRSA requires a specific type of antibiotic for treatment.

Common treatment strategies for impetigo include:

  • Mupirocin (Bactroban): This ointment can be used to treat mild impetigo as it can gently cleanse and remove the crusts formed on the blisters.

Oral antibiotic medication used in severe cases of bullous impetigo:

  • Penicillin derivatives like Augmentin and cephalosporins like cephalexin (Keflex) are helpful. Other antibiotics like clindamycin or trimethoprim-sulfamethoxazole may be necessary for MRSA strands.

Some complications associated with the condition are:

  • Scarlet fever
  • Staphylococcal scalded skin syndrome (SSSS)
  • Osteomyelitis
  • Septic arthritis
  • Septicemia
  • Guttate psoriasis
  • Cellulitis
  • Erysipelas
  • Urticaria
  • Pedal edema
  • Transient proteinuria
  • Hematuria

Similar to other contagious diseases, the spread of impetigo can be curbed by following some simple steps like always using a clean washcloth or towel, not sharing personal care products like razors or towels, not touching oozing blisters and a thorough washing of the hands in case of contact with an infected individual. With a little bit of care from our side, we can easily reduce the spread of contagious diseases like impetigo.

The content of this Website is for informational purposes only, is general in nature and is not intended to diagnose, treat, cure or prevent any disease, and does not constitute professional advice. The information on this Website should not be considered as complete and does not cover all diseases, ailments, physical conditions, or their treatment. You should consult with your physician before beginning any exercise, weight loss, or health care program and/or any of the beauty treatments.


References

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Gazewood, J. D. (2007, March 15). Diagnosis and Treatment of Impetigo. Retrieved from https://www.aafp.org/afp/2007/0315/p859.html

Impetigo. (n.d.). Retrieved from https://www.scribd.com/document/309492112/Impetigo

Geria, A. N., & Schwartz, R. A. (2010, February). Impetigo update: New challenges in the era of methicillin resistance. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20349679

Treating impetigo in primary care. (2007, January). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17367045

George, A., & Rubin, G. (2003, June). A systematic review and meta-analysis of treatments for impetigo. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12939895

Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. (2014, August 28). Retrieved from https://www.us.elsevierhealth.com/mandell-douglas-and-bennetts-principles-and-practice-of-infectious-diseases-9781455748013.html

A-Z Health Library. (n.d.). Retrieved from https://www.pediatrix.com/sitemaker/websitefiles/WestPalm7471540/body.cfm?id=15&action=detail&AEArticleID=000860&AEProductID=Adam2004_1&AEProjectTypeIDURL=APT_1

Topical Therapies for Impetigo: Pediatric Emergency Care. (n.d.). Retrieved from https://journals.lww.com/pec-online/Citation/2010/03000/Topical_Therapies_for_Impetigo.14.aspx