Dermatology - Bullous Impetigo

Dermatology - Bullous Impetigo
The primary causative agents of impetigo are Staphylococcus aureus and beta-hemolytic Streptococcus group A. Bullous impetigo occurs due to the localized synthesis of epidermolytic toxin by S. aureus bacteria. These microorganisms are not commonly found on human skin, but instead temporarily inhabit the skin and produce surface-level diseases. Primary infections primarily affect youngsters, however both primary and secondary infections can occur in individuals of all age groups.
Superficial infections frequently lack noticeable symptoms.

Impetigo manifests as erosions characterized by golden-yellow crusts measuring 1 to over 3 cm in diameter. These lesions exhibit central healing after several weeks of presence. The lesions are distributed randomly, apart from each other, and might merge together; satellite lesions appear due to self-infection. Secondary infection is frequently observed. Bullous impetigo manifests as blisters filled with transparent yellow or slightly cloudy fluid, surrounded by a red ring, on skin that appears normal. Rupture causes the decompression of bullous lesions. Removing the ceiling of a bulla results in the formation of a shallow and wet erosion.
Ecthyma is a condition characterized by the presence of ulcers covered by a thick crust that can be painful and hardened.


The diagnosis is based on clinical observations and is verified through culture testing. The differential diagnosis comprises excoriation, allergic contact dermatitis, herpes simplex, epidermal dermatophytosis, scabies, burns, porphyria cutanea tarda, venous stasis, and ischemic ulcers.

Manage lesions by applying mupirocin and retapamulin ointment. To avoid future occurrences, use benzoyl peroxide wash and/or apply mupirocin and retapamulin ointment to the nostrils.
Examine family members for symptoms of impetigo and advise any individuals in close proximity to cleanse their hands with ethanol or isopropyl gel.