Impetigo infection

 'Impetigo'  is a contagious skin infection affecting the surface layers of the skin. It is relatively common, affects children and adults, and is spreading rapidly, especially in children's groups.

Etiology and pathogenesis
Impetigo is a bacterial disease caused by either the  Streptococcus pyogenes  or  Staphylococcus aureus  bacteria. According to the causing agent, we distinguish between three forms:
 *  'Maculovesicular'  - streptococcal;
 *  'Bullous'  - staphylococcal - bullae are formed by cleavage of the epidermis by staphylococcal exotoxins - exfoliatins (A and B);
 * Impetigo elbow.jpg 'Mixed'  - streptococcal and staphylococcal infection. It is the most common.

Clinical course

 *  'Maculovesicular'  form begins with red macules, which gradually turn into blisters. Initially, the serous contents become cloudy and a pustule is formed. Pustules can resemble acne. The pustules crack and honey-yellow crusts form from the dried secretion.
 *  'Bullous'  form is characterized by large blisters that rupture rapidly, leaving red wetting deposits. Impetigo can occur anywhere on the body, but the most common location is the face.

Diagnosis
The diagnosis is made according to the characteristic clinical course. In unclear cases, a bacteriological examination is performed. Differential diagnosis:
 * HSV;
 * Tinea;
 * Dermatitis seborrhoica;
 * Contact Dermatitis.

Treatment

 * Application of antiseptic solutions or ointments (mupirocin, fusidic acid, bacitracin);
 * Gentle crust removal with keratolytic gauze ointments (Saloxyl unguentum containing salicylic acid);
 * Hygienic measures preventing transmission (own towels, bed linen, etc.);
 * Treat all lesions at once;
 * Minimize friction with clothing or bandages (easy abrasion infection);
 * General therapy in case of failure of local treatment or extensive manifestations (general antibiotic therapy);
 * When group A streptococci are detected, also general antibiotic treatment as prevention glomerulonephritis and urine examination after one month.

Complications
There is a certain risk of developing complications, but they are not common.
 * Glomerulonephritis;
 * Scalded skin syndrome.

Prognosis in case of this disease is good.

Related articles

 * Furunkl
 * Carbunkl
 * Pyoderma
 * Exudative interstitial inflammation

Literature

 * ŠTORK, Jiří, et al. Dermatovenerologie. 1. vydání. Praha : Galén, 2008. 502 s. s. 88-89.  ISBN 978-80-7262-371-6.