impetigo

Definition

Impetigo refers to a very localized bacterial infection of the skin. There are two types, bullous and epidemic.

Description

Impetigo is a skin infection thatwhich tends primarily to afflict children. Impetigo caused by the bacterium Staphylococcus aureus (also known as staph) affects children of all ages. Impetigo caused by the bacteria called group A streptococci (also know as strep) are most common in children ages two to five.

The bacteria that cause impetigo are very contagious. They can be spread by a child from one part of his or her body to another by scratching, or contact with a towel, clothing, or stuffed animal. These same methods can pass the bacteria on from one person to another.

Impetigo tends to develop in areas of the skin that have already been damaged through some other mechanism (a cut or scrape, burn, insect bite, or vesicle from chickenpox).

— Rosalyn Carson-DeWitt, MD

[Middle English, from Latin impetīgō, from impetere, to attack. See impetus.]

An inflammatory disease of the skin; characterized by pustules.

Impetigo. (Zitelli/Davis, 2002. Courtesy of Michael Sherlock, MD, Lutherville, MD

Definition

Impetigo is a contagious bacterial infection of the skin. It primarily afflicts children and the elderly. Ecthyma is a more severe form of impetigo with sores affecting a deeper layer of the skin. It often leaves scarring and discoloration of the skin.

Description

The first sign of impetigo is a clear, fluid-filled bump, called a vesicle, which appears on the skin. The vesicle soon dries out and develops a scab-like, honey-colored crust, which breaks open and leaks fluid. These vesicles usually appear grouped closely together, and they may spread out and cover a large area of the skin. Impetigo often affects the area around the nose and mouth; however, it can spread to anywhere on the skin, but especially the arms and legs, as well as the diaper areas of infants. The condition called ecthyma is a form of impetigo in which the sores that develop are larger, filled with pus, and covered with brownish-black scabs that may lead to scarring. Impetigo infections most commonly occur during warmer weather.

Causes & Symptoms

Impetigo is most frequently caused by the bacteria Staphylococcus aureus, also known as "staph," and less frequently, by group A beta-hemolytic streptococci, also known as "strep." These bacteria are highly contagious. Impetigo can quickly spread from one part of the body to another through scratching. It can also be spread to other people if they touch the infected sores or if they have contact with the soiled clothing, diapers, bed sheets, or toys of an infected person. Such factors as heat, humidity, crowded conditions, and poor hygiene increase the chance that impetigo will spread rapidly among large groups.

Impetigo tends to develop in areas of the skin that have already been damaged through some other means such as injury, insect bite, sunburn, diaper rash, chicken pox, or herpes, especially oral herpes. The sores tend to be very itchy, and scratching may lead to the spread of the disease. Keeping the hands washed with antibacterial soap and fingernails well trimmed are good precautions for limiting further infection.

Diagnosis

Observation of the appearance, location and pattern of sores is the usual method of diagnosis. Fluid from the vesicles can be cultured and examined to identify the causative bacteria.

Treatment

Echinacea tincture can be applied directly to the skin. The homeopathic remedy Antimonium tartaricum can be used when impetigo affects the face.

Bag Balm, an anti-bacterial salve, can be applied to sores to relieve pain and heal the skin.

A tincture of the pansy flower, Viola tricolor, can be taken internally twice daily for a week to speed healing.

Burdock root oil can be directly applied to the skin to help it heal.

Topical washes with goldenseal, grapefruit seed extract (which may sting), or tea tree oil are also recommended.

Allopathic Treatment

Uncomplicated impetigo is usually treated with a topical antibiotic cream such as mupirocin (Bactroban). Oral antibiotics are also commonly prescribed. Patients are advised to wash the affected areas with an antibacterial soap and water several times per day, and to otherwise keep the skin dry. Scratching is discouraged, and the suggestion is that nails be cut or that mittens be worn—especiallly with young children. Ecthyma is treated in the same manner, but at times may require surgical debridement, or removal of the affected area.

Expected Results

The vast majority of those with impetigo recover quickly, completely, and uneventfully. However, there is a chance of developing a serious disease, or sequela, especially if the infection is left untreated. Local spread of the infection can cause osteomyelitis, septic arthritis, cellulitis, or lymphangitis. If large quantities of the bacteria begin to circulate in the bloodstream, there is also a danger of developing a systemic infection such as glomerulonephritis or pneumonia.

Prevention

Prevention of impetigo involves good hygiene. In order to avoid spreading the infection from one person to another, those with impetigo should be isolated until all sores are healed, and their used linen, clothing, and toys should be kept out of contact with others.

Resources

Books

Foley, Denise, et al. The Doctors Book of Home Remedies for Children: From Allergies and Animal Bites to Toothache and TV Addiction, Hundreds of Doctor-Proven Techniques and Tips to Care for Your Kid. Emmaus, PA: Rodale Press, 1999.

Shaw, Michael, ed., et al. Everything You Need to Know About Diseases. Springhouse, PA: Springhouse Corporation, 1996.

Weed, Susun. Healing Wise. New York: Ash Tree Publishing, 1989

Other

The Nemours Foundation. http://kidshealth.org/parent/general/infections/impetigo.html.

[Article by: Patience Paradox]

Definition

Impetigo refers to a very localized bacterial infection of the skin. There are two types, bullous and epidemic.

Description

Impetigo is a skin infection that tends primarily to afflict children. Impetigo caused by the bacterium Staphylococcus aureus (also known as staph) affects children of all ages. Impetigo caused by the bacteria called group A streptococci (also known as strep) are most common in children ages two to five.

The bacteria that cause impetigo are very contagious. They can be spread by a child from one part of his or her body to another by scratching or contact with a towel, clothing, or stuffed animal. These same methods can pass the bacteria on from one person to another.

Impetigo tends to develop in areas of the skin that have already been damaged through some other mechanism (a cut or scrape, burn, insect bite, or vesicle from chickenpox).

Demographics

About 10 percent of all skin problems in children are ultimately diagnosed as impetigo.

Causes and Symptoms

The first sign of bullous impetigo is a large bump on the skin with a clear, fluid-filled top (a vesicle). The bump develops a scab-like, honey-colored crust. There is usually no redness or pain, although the area may be quite itchy. Ultimately, the skin in this area will become dry and flake away. Bullous impetigo is usually caused by staph bacteria.

Epidemic impetigo can be caused by staph or strep bacteria and (as the name implies) is very easily passed among children. Certain factors, such as heat and humidity, crowded conditions, and poor hygiene increase the chance that this type of impetigo will spread rapidly among large groups of children. This type of impetigo involves the formation of a small vesicle surrounded by a circle of reddened skin. The vesicles appear first on the face and legs. When a child has several of these vesicles close together, they may spread to one another. The skin surface may become eaten away (ulcerated), leaving irritated pits. When there are many of these deep, pitting ulcers, with pus in the center and brownish-black scabs, the condition is called ecthyma. If left untreated, the type of bacteria causing this type of impetigo has the potential to cause a serious kidney disease (glomerulonephritis). Even when impetigo is initially caused by strep bacteria, the vesicles are frequently secondarily infected with staph bacteria.

Impetigo is usually an uncomplicated skin condition. Left untreated, however, it may develop into a serious disease, including osteomyelitis (bone infection), septic arthritis (joint infection), or pneumonia. If large quantities of bacteria are present and begin circulating in the bloodstream, the child is in danger of developing an overwhelming systemic infection known as sepsis.

Diagnosis

Characteristic appearance of the skin is the usual method of diagnosis, although fluid from the vesicles can be cultured and then examined in an attempt to identify the causative bacteria.

Treatment

Uncomplicated impetigo is usually treated with a topical antibiotic cream called mupirocin. In more serious, widespread cases of impetigo, or when the child has a fever or swollen glands, antibiotics may be given by mouth or even through a needle placed in a vein (intravenously).

Prognosis

Prognosis for a child with impetigo is excellent. The vast majority of children recover quickly, completely, and uneventfully.

Prevention

Prevention involves good hygiene. Hand washing; never sharing towels, clothing, or stuffed animals; and keeping fingernails well-trimmed are easy precautions to take to avoid spreading the infection from one person to another.

Resources

Books

"Cutaneous Bacterial Infections." In Nelson Textbook of Pediatrics. Edited by Richard E. Behrman et al. Philadelphia: Saunders Company, 2004.

Darmstadt, Gary L. "Cellulitis and Superficial Skin Infections." In Principles and Practice of Pediatric Infectious Diseases, 2nd ed. Edited by Sarah S. Long et al. St. Louis, MO: Elsevier, 2003.

Periodicals

Sanfilippo, A. M. "Common bacterial skin infections." American Family Physician 66 (July 2002): 119–24.

Stulberg, D. L. "Common pediatric and adolescent skin conditions." American Family Physician 16 (October 2003): 269–83.

Wolfrey, J. "Pediatric exanthems." Clinical Family Practice 5 (September 2003): 55–7.

[Article by: Rosalyn Carson-DeWitt, MD]

For more information on impetigo, visit Britannica.com.

A skin disorder caused primarily by the bacterium Staphylococcus aureus or a streptococcus that infects a minor skin trauma, such as an abrasion. It is characterized by small pus-filled blisters and fever. It is extremely contagious and should preclude participation in all contact or collision sports until the lesions are dry. It is treated with a systemic antibiotic.

Usually a staphylococcal skin infection marked by vesicles or bullae that become pustular, rupture, and form yellow crusts. In animals a superficial infection of the face of newborn piglets, the abdominal skin of puppies, and one of the teats of cows, go under the name of impetigo. See also udder impetigo, contagious porcine pyoderma.

• i. contagiosa — see exudative epidermitis.

For the band, see Impetigo (band).

Impetigo
Classification and external resources
Impetigo Skin Lesions
ICD-10	L01.
ICD-9	684
DiseasesDB	6753
MedlinePlus	000860
eMedicine	derm/195 emerg/283 med/1163 ped/1172
MeSH	D007169

Impetigo (sometimes impetaigo) is a superficial bacterial skin infection most common among school children. People who play close contact sports such as rugby, American football and wrestling are also susceptible, regardless of age. Impetigo is not as common in adults. It is also highly contagious. The name derives from the Latin impetere ("assail"). It is also known as school sores.^[1]

Contents 1 Causes 2 Diagnosis 3 Transmission 4 Prevention 5 Types 5.1 Impetigo contagiosa 5.2 Bullous impetigo 5.3 Ecthyma 6 Treatment 7 References 8 External links

Causes

It is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes.^[2] According to the American Academy of Family Physicians, both bullous and nonbullous are primarily caused by Staphylococcus aureus, with Streptococcus also commonly being involved in the nonbullous form."^[3]

Diagnosis

Impetigo generally appears as honey-colored scabs formed from dried serum, and is often found on the arms, legs, or face.^[2]

Transmission

The infection is spread by direct contact with lesions or with nasal carriers. The incubation period is 1–3 days. Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.

Prevention

This section does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (March 2009)

Good hygiene practices can help prevent impetigo from spreading. Those who are infected should use soap and water to clean their skin and take baths or showers regularly. Non-infected members of the household should pay special attention to areas of the skin that have been injured, such as cuts, scrapes, insect bites, areas of eczema, and rashes. These areas should be kept clean and covered to prevent infection. In addition, anyone with impetigo should cover the impetigo sores with gauze and tape. All members of the household should wash their hands thoroughly with soap on a regular basis. It is also a good idea for everyone to keep their fingernails cut short to make hand washing more effective. Contact with the infected person and his or her belongings should be avoided, and the infected person should use separate towels for bathing and hand washing. If necessary, paper towels can be used in place of cloth towels for hand drying. The infected person's bed linens, towels, and clothing should be separated from those of other family members, as well. Whilst suffering from impetigo, it is best to stay indoors for a few days to stop any bacteria from getting into the blisters and making the infections worse. When a person has impetigo, it is common for him/her to get it a second time in the space of 6–9 months. This usually occurs in persons aged 12–16.

Types

Impetigo contagiosa

Impetigo contagiosa is a cutaneous condition characterized by a staphylococcal, streptococcal, or combined infection that presents with discrete, thin-walled vesicles pustular and then rupture.^[4]:255 People who suffer from cold sores have shown higher chances of suffering from impetigo.^{[citation needed]} Those who normally suffer from cold sores should consult a doctor if normal treatment has no effect. Impetigo also causes flu-like symptoms which may cause fatigue, weakness of muscles, headaches and vomiting.^{[citation needed]}

Bullous impetigo

Bullous impetigo primarily affects infants and children younger than 2 years. It causes painless, fluid-filled blisters — usually on the trunk, arms and legs. The skin around the blister is usually red and itchy but not sore. The blisters, which break and scab over with a yellow-colored crust, may be large or small, and may last longer than sores from other types of impetigo.

Ecthyma

Ecthyma is a more serious form of impetigo in which the infection penetrates deeper into the skin's second layer, the dermis. Signs and symptoms include:

• Painful fluid- or pus-filled sores that turn into deep ulcers, usually on the legs and feet
• A hard, thick, gray-yellow crust covering the sores
• Swollen lymph glands in the affected area
• Little holes the size of pinheads to the size of pennies appear after crust recedes
• Scars that remain after the ulcers heal

Treatment

For generations, the disease was treated with an application of the antiseptic gentian violet.^[5] Today, topical or oral antibiotics are usually prescribed. Treatment may involve washing with soap and water and letting the impetigo dry in the air. Mild cases may be treated with bactericidal ointment, such as fusidic acid, mupirocin, chloramphenicol or neosporin, which in some countries may be available over-the-counter. More severe cases require oral antibiotics, such as dicloxacillin, flucloxacillin or erythromycin. Alternatively amoxicillin combined with clavulanate potassium, cephalosporins (1st generation) and many others may also be used as an antibiotic treatment.

References

1. ^ Impetigo - school sores - Better Health Channel
2. ^ ^{a b} Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 843 ISBN 978-1-4160-2973-1
3. ^ Stulberg DL, Penrod MA, Blatny RA (2002). "Common bacterial skin infections.". American family physician 66 (1): 119–24. PMID 12126026. http://www.aafp.org/afp/20020701/119.html. 
4. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
5. ^ http://www.bmj.com/cgi/content/full/329/7472/979

External links

• NIH/Medline
• Photo (University of Iowa)
• Dermnet NZ
• Merck Manual (professional)

v • d • e Diseases of the skin and appendages by morphology Growths Epidermal wart · callus · seborrheic keratosis · acrochordon · molluscum contagiosum · actinic keratosis · squamous cell carcinoma · basal cell carcinoma · merkel cell carcinoma · nevus sebaceous · trichoepithelioma Pigmented Freckles · lentigo · melasma · nevus · melanoma Dermal and subcutaneous epidermal inclusion cyst · hemangioma · dermatofibroma · keloid · lipoma · neurofibroma · xanthoma · Kaposi's sarcoma · infantile digital fibromatosis · granular cell tumor · leiomyoma · lymphangioma circumscriptum · myxoid cyst Rashes With epidermal involvement Eczematous contact dermatitis · atopic dermatitis · seborrheic dermatitis · stasis dermatitis · lichen simplex chronicus · Darier's disease · glucagonoma syndrome · langerhans cell histiocytosis · lichen sclerosus · pemphigus foliaceus · Wiskott-Aldrich syndrome · Zinc deficiency Scaling psoriasis · tinea (corporis · cruris · pedis · manuum · faciei) · pityriasis rosea · secondary syphillis · mycosis fungoides · systemic lupus erythematosus · pityriasis rubra pilaris · parapsoriasis · ichthyosis Blistering herpes simplex · herpes zoster · varicella · bullous impetigo · acute contact dermatitis · pemphigus vulgaris · bullous pemphigoid · dermatitis herpetiformis · porphyria cutanea tarda · epidermolysis bullosa simplex Papular scabies · insect bite reactions · lichen planus · miliaria · keratosis pilaris · lichen spinulosus · transient acantholytic dermatosis · lichen nitidus · pityriasis lichenoides et varioliformis acuta Pustular acne vulgaris · acne rosacea · folliculitis · impetigo · candidiasis · gonococcemia · dermatophyte · coccidioidomycosis · subcorneal pustular dermatosis Hypopigmented tinea versicolor · vitiligo · pityriasis alba · postinflammatory hyperpigmentation · tuberous sclerosis · idiopathic guttate hypomelanosis · leprosy · hypopigmented mycosis fungoides Without epidermal involvement Red Blanchable Erythema Generalized drug eruptions · viral exanthems · toxic erythema · systemic lupus erythematosus Localized cellulitis · abscess · boil · erythema nodosum · carcinoid syndrome · fixed drug eruption Specialized urticaria · erythema (multiforme · migrans · gyratum repens · annulare centrifugum · ab igne) Nonblanchable Purpura Macular thrombocytopenic purpura · actinic purpura Papular disseminated intravascular coagulation · vasculitis Indurated scleroderma/morphea · granuloma annulare · lichen sclerosis et atrophicus · necrobiosis lipoidica Miscellaneous disorders Ulcers Hair telogen effluvium · androgenic alopecia · trichotillomania · alopecia areata · systemic lupus erythematosus · tinea capitis · loose anagen syndrome · lichen planopilaris · folliculitis decalvans · acne keloidalis nuchae Nail onychomycosis · psoriasis · paronychia · ingrown nail Mucous membrane aphthous stomatitis · oral candidiasis · lichen planus · leukoplakia · pemphigus vulgaris · mucous membrane pemphigoid · cicatricial pemphigoid · herpesvirus · coxsackievirus · syphilis · systemic histoplasmosis · squamous cell carcinoma

v • d • e Diseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709) Infections Bacterial skin disease Staphylococcus (Staphylococcal scalded skin syndrome, Impetigo, Boil, Carbuncle) · Strep (Impetigo) · Corynebacterium (Erythrasma) Viral skin disease Wart · Molluscum contagiosum · Erythema infectiosum · Exanthema subitum · Herpes simplex (Herpetic whitlow, Eczema herpeticum) General Cellulitis (Paronychia) · Acute lymphadenitis · Pilonidal cyst · Pimple (Pustule) Bullous disorders acantholysis (Pemphigus, Transient acantholytic dermatosis) · Pemphigoid (Bullous, Cicatricial, Gestational) · Dermatitis herpetiformis Inflammatory Dermatitis and eczema Atopic dermatitis · Seborrhoeic dermatitis (Dandruff, Cradle cap) · Contact dermatitis (Diaper rash, Urushiol-induced contact dermatitis) · Erythroderma · Lichen simplex chronicus/Prurigo nodularis · Itch (Pruritus ani, Pruritus scroti, Pruritus vulvae) · Nummular dermatitis · Dyshidrosis · Pityriasis alba Papulosquamous disorders Psoriasis (Psoriatic arthritis) · Parapsoriasis (Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica, Lymphomatoid papulosis) · other pityriasis (Pityriasis rosea, Pityriasis rubra pilaris) · other lichenoid (Lichen planus, Lichen nitidus) Urticaria Dermatographic urticaria · Cold urticaria · Cholinergic urticaria · Solar urticaria Erythema Erythema multiforme/drug eruptions: Stevens-Johnson syndrome · Toxic epidermal necrolysis · Erythema nodosum Other erythema: Erythema annulare centrifugum · Erythema marginatum · Keratolytic winter erythema · Necrolytic migratory erythema · Erythema toxicum Radiation-related disorders Sunburn · actinic rays (Actinic keratosis, Actinic cheilitis) · Polymorphous light eruption (Acne aestivalis) · Radiodermatitis · Erythema ab igne Pigmentation/ Dyschromia hypopigmentation (Albinism, Vitiligo) · hyperpigmentation (Melasma, Freckle, Café au lait spot, Lentigo/Liver spot, Acanthosis nigricans, Acral acanthotic anomaly) Other skin keratosis/hyperkeratosis (Seborrheic keratosis, Callus) · other epidermal thickening (Ichthyosis acquisita, Palmoplantar keratoderma) skin ulcer (Pyoderma gangrenosum, Bedsore) Cutaneous Markers of Internal Malignancy (Florid cutaneous papillomatosis, acanthosis nigricans, sign of Leser-Trelat) atrophic (Lichen sclerosus, Acrodermatitis chronica atrophicans) necrobiosis (Granuloma annulare, Necrobiosis lipoidica) · other granuloma (Granuloma faciale, Pyogenic granuloma) cutaneous vasculitis (Livedoid vasculitis, Erythema elevatum diutinum) Connective tissues collagen disease: Keloid localized connective tissue disorders: Lupus erythematosus (Discoid lupus erythematosus, Subacute cutaneous lupus erythematosus) · Scleroderma/Morphea · Linear scleroderma · Calcinosis cutis · Sclerodactyly · Ainhum integument, SF, LCT navs: anat/physio, noncongen/congen/neoplasia, symptoms+signs/eponymous, proc

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

Dansk (Danish)
n. - børnesår, impetigo

Nederlands (Dutch)
soort huidziekte (krentenbaard)

Français (French)
n. - impétigo

Deutsch (German)
n. - (Med.) Impetigo, Eiterflechte

Ελληνική (Greek)
n. - (παθολ.) πυοφύτης, μολυσματικό κηρίο

Italiano (Italian)
impetigine

Português (Portuguese)
n. - impetigo (m) (Patol.)

Русский (Russian)
кожная сыпь, импетиго

Español (Spanish)
n. - impétigo

Svenska (Swedish)
n. - impetigo (svinkoppor)

中文（简体）(Chinese (Simplified))
脓疱病

中文（繁體）(Chinese (Traditional))
n. - 膿皰病

한국어 (Korean)
n. - 농가진

日本語 (Japanese)
n. - 膿痂疹

العربيه (Arabic)
‏(الاسم) الحصف : داء جلدي‏

עברית (Hebrew)
n. - ‮סעפת (מחלה)‬

If you are unable to view some languages clearly, click here.

To select your translation preferences click here.