What is Impetigo?

Impetigo is a common, superficial, extremely infectious bacterial infection of the skin generally caused by group A beta-hemolytic streptococcus, staphylococcus aureus or by multiple bacteria.

The mode of transmission is via direct contact with lesions and with nasal carriers. Dried streptococci suspended in the air are not transmittable to the intact skin. The period of incubation is 1 to 3 days. It is very contagious and infection may spread from one body area to other exposed areas of the body and may infect other people sharing with them their clothing, linen, towels, combs and other personal belongings soiled with exudates.

At first, the lesions appear as small, red pustules which quickly become isolated, thin-walled vesicles which will soon rupture leaving a denuded area that discharges a honey-like serous liquid. After it hardens on the skin surface, they become covered with stuck-on golden yellow crusts. Removing the crust will expose the smooth, red, moist surface on which new crust will form again.

There are two categories of impetigo namely bullous impetigo and non-bullous impetigo. Bullous impetigo involves larger fluid-containing vesicles that is clear at first and then becomes hazy. The most widespread type of impetigo is the non-bullous. In reverse to bullous impetigo, the blisters in non-bullous are tiny. These blisters will burst open in the end leaving a raw patch of red skin that suppurates fluid. Steadily, a honey-yellow coating coats the area.

Frequent hand washing and other good hygiene measures can facilitate prevention. Take baths regularly and clean the skin with mild soap and water. Prevent spreading the infection among members of the family by using a separate towel. Separate the infected individual’s personal belongings and wash the items in hot water. Other members who are not infected should pay special care to areas of the skin with impaired integrity and keep it clean and protected from getting infected. Persons who have impetigo are advised to stay indoors for a few days.

If the affected area is extensive and there is a concern about complications, then systemic antibiotic therapy is the usual treatment. Oral penicillin may be prescribed to patients with nonbullous impetigo. Penicillinase-resistant penicillins are recommended to patients who have bullous impetigo. If the patient has previous allergic reaction to penicillin, erythromycin is a useful substitute. If the disease is just limited to a small area, a topical antibiotic may be prescribed. An alternative to topical antibiotics is hydrogen peroxide.



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