Impetigo

Clinical Description

Bacterial infection affecting the uppermost layer of the epidermis (stratum corneum).

Risks factors:

• Young age
• Immunosuppression
• Presence of underlying skin disease which compromise the integrity of the skin e.g., atopic dermatitis, tinea corporis, ulcers.

Cause

• Staphylococcal aureus and Streptococcal pyogenes

Signs and Symptoms

• Blisters, vesicles, or pustules that break easily
• Honey coloured/yellowish crusts
• Skin erosions
• Itch may or may not be present

Investigations

• Diagnosis usually clinical
• Pus Swab to confirm diagnosis where necessary or if not responsive to therapy

Treatment

• Keep infected areas clean:
• wash daily with soap and clean water
• Wash off crusts with clean water to expose clean raw base

Prevent spread to others -

• Frequently wash towels, beddings and clothes used and stained by the patient

Treatment

• Localised/small area involved:
• Fusidic acid 20mg/g cream 12hourly for 7 days
• Apply Gentian Violet paint 0.5 % after crusts have been removed from the affected area
• treat underlying skin disease e.g., eczema or tinea if present to remove source of infection
• If extensive give oral antibiotics
• For children:
• Flucloxacillin 12.5mg/kg body weight 6 hourly for 5-7
• Children if allergic to penicillin:
• Give Erythromycin 125-500mg P.O 6 hourly for 5-7 days

Adults

• Flucloxacillin 500 mg P.O 6 hourly for 5 – 7 days if allergic to penicillin

Adults

• Erythromycin 500 mg P.O 6 hourly for 7 days