Impetigo
Symptoms
Impetigo presents as honey‑colored crusts on red bases, often on the face or extremities. Bullous impetigo forms larger blisters that rupture easily. Lesions may itch or burn but are usually painless. Regional swelling of lymph nodes can occur. In children, the infection spreads rapidly via scratching or close contact.
Cause
Staphylococcus aureus and Streptococcus pyogenes infect superficial skin layers through minor trauma. Warm, humid environments and crowded conditions facilitate transmission. Nasal carriage of staph acts as a reservoir for reinfection. Poor hygiene and eczema increase susceptibility. The bacteria produce toxins that cause blister formation in bullous types.
Treatment
Topical mupirocin or retapamulin treats localized non‑bullous impetigo. Oral antibiotics effective against staph and strep are used for extensive disease or bullous forms. Keeping lesions clean, covered, and fingernails short prevents spread. Children should stay home from school until 24 hours of antibiotic therapy has passed. Treating nasal carriers with mupirocin can reduce recurrence.
Dr. Beth Schulz-Butulis
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