1. 1
IMPETIGO
DEFINITION
• Impetigo is a common infection which affects superficial layers of epidermis that is highly
contagious and most commonly caused by gram positive bacteria.
• There are two ways an initial infection can occur:
• Primary impetigo - is when the bacteria invade the skin through a cut, insect bite, or other
injury.
• Secondary impetigo - is where the bacteria invade the skin because the skin barrier has been
disrupted by another skin infection, such as scabies or eczema.
INCUBATION PERIOD:
The incubation period of impetigo can vary, but it typically ranges from 1 to 3 days after
exposure to the bacteria.
EPIDEMIOLOGY:
• The bullous form most frequently affects neonates and accounts for approximately 10% of all
cases of impetigo.
• Based on data from studies published since 2000 from low and low-middle income countries,
we estimate the global population of children suffering from impetigo at any one time to be in
excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-
recognized disease and in conjunction with scabies, comprises a major childhood dermatological
condition with potential lifelong consequences if untreated.
OCCURRENCE:
• On exposed skin mainly on face.
• Most common during hot, humid weather, which facilitates microbial colonization of the skin.
2. 2
• Minor trauma, such as scratches or insect bites, then allows entry of organisms into the
superficial layers of skin, and infection ensues.
CAUSES:
• Caused by S. pyogenes.
• But S. aureus either alone or in combination with S. pyogenes has emerged more recently as
the principal cause of impetigo
• The bullous form is caused by strains of S. aureus capable of producing exfoliative toxins
• Based on clinical presentations:
TYPES:
BULLOUS IMPETIGO (BLISTERS): This form is caused by staph bacteria that produce a
toxin that causes a break between the top layer (epidermis) and the lower levels of skin forming a
blister. (The medical term for blister is bulla.) Blisters can appear in various skin areas,
especially the buttocks, though these blisters are fragile and often break and leave red, raw skin
with a ragged edge. No prior trauma is needed for these blisters to appear.
NON -BULLOUS IMPETIGO: This is the common form, caused by both staph and strep
bacteria. It appears as small blisters or scabs, which then form yellow or honey-colored crusts.
These often start around the nose and on the face, but they also may affect the arms and legs. At
time, there may be swollen glands nearby.
SYMPTOMS:
• Pruritus (severe itching) 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 sometimes are seen with bullous impetigo.
IS IMPETIGO CONTAGIOUS?
3. 3
• Impetigo is contagious, mostly from direct contact with someone who has it.
• Can be transmitted through:
1. Towels
2. Toys
3. Clothing or
4. Household items
DIAGNOSIS:
• Doctors generally diagnose impetigo by looking at the distinctive sores.
• Sometimes culture test are done rarely to identify the type of bacteria causing lesions.
• A complete blood count is often performed because leukocytosis is common.
TREATMENT:
• Impetigo is not serious, may go away and dry up on its own, and is easy to treat.
• Mild cases can be handled by gentle cleansing, removing crusts, and applying the prescription-
strength antibiotic ointment mupirocin (Bactroban).
• More severe or widespread cases, especially of bullous impetigo, may require oral antibiotic
medication for impetigo.
• Impetigo may resolve spontaneously, antimicrobial treatment is indicated to relieve symptoms,
prevent formation of new lesions, and prevent complications, such as cellulitis.
• With proper treatment, healing of skin lesions generally is rapid and occurs without residual
scarring.
• Removal of crusts by soaking in soap and warm water also may be helpful in providing
symptomatic relief.
PREVENTION:
4. 4
Hand Hygiene: Wash hands regularly with soap and water.
Clean and Dry Skin: Keep the skin clean and dry through regular bathing.
Avoid Touching Lesions: Refrain from touching impetigo lesions.
Clean Towels and Bedding: Wash towels, bed linens, and clothing regularly; avoid sharing.
Respiratory Hygiene: Cover mouth and nose when coughing or sneezing.
Short Fingernails: Keep fingernails short to prevent scratching.
Limit Close Contact: Avoid close contact with individuals with impetigo.
Prompt Medical Attention: Seek medical help promptly for suspected impetigo.
Complete Antibiotic Treatment: Finish the full course of prescribed antibiotics.
Educate Children: Teach children about good hygiene practices.
