Impetigo Symptom & Treatment
Impetigo is a superficial skin infection that is seen most commonly in children. It is highly communicable and spreads through close contact. Most cases are caused by S. pyogenes, but S. aureus either alone or in combination with S. pyogenes has emerged as a principal cause of impetigo.
- Exposed skin, especially the face, is the most common site for impetigo.
- Pruritus is common, and scratching of the lesions may further spread infection through excoriation of the skin.
- Other systemic signs of infection are minimal.
- Weakness, fever, and diarrhea are sometimes seen with bullous impetigo.
- Nonbullous impetigo manifests initially as small, fluid-filled vesicles. These lesions rapidly develop into pus-filled blisters that readily rupture. Purulent discharge from the lesions dries to form golden yellow crusts that are characteristic of impetigo.
- In the bullous form of impetigo, the lesions begin as vesicles and turn into bullae containing clear yellow fluid. Bullae soon rupture, forming thin, light brown crusts.
- Regional lymph nodes may be enlarged.
- Penicillinase-resistant penicillins (such as dicloxacillin 12.5 mg/kg orally daily in for divided doses for children) are the agents of first choice because of the increased isolation of S. aureus. First-generation cephalosporins (such as cephalexin 25 to 50 mg/kg orally daily in two divided doses for children) are also effective. Penicillin may be used for impetigo caused by S. pyogenes. It may be administered as either a single intramuscular dose of benzathine penicillin G (300,000 to 600,000 units in children, 1.2 million units in adults) or as oral penicillin VK given for 7 to 10 days.
- Penicillin-allergic patients can be treated with oral clindamycin (adults 150 to 300 mg orally every 6 to 8 hours; children 10 to 30 mg/kg per day in three to four divided doses)
- The duration of therapy is 7 to 10 days.
- Mupirocin ointment is as also effective.