​Dermatology - Impetigo

​Dermatology - 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 Staphylococcus aureus bacteria. These microorganisms are not commonly found in the normal human skin microbiota, but instead temporarily inhabit the skin and can lead to surface-level diseases. Primary infections are most prevalent in 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 of 1 to 3 cm in diameter. These lesions exhibit central healing after several weeks of presence. The lesions are spread out, separate, and might merge together; satellite lesions form by self-infection. Secondary infection is frequently observed. Bullous impetigo is characterized by the presence of blisters filled with clear yellow or slightly cloudy fluid, surrounded by a red ring, on skin that appears normal. Rupture leads to the decompression of bullous lesions. Removing the roof of a bulla results in the formation of shallow and wet erosion. Ecthyma is characterized by the presence of ulceration accompanied by a thick crust that adheres firmly to the skin. This condition may cause tenderness and hardening of the affected area.


The diagnosis is made based on clinical observations and validated through laboratory 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, and prevent them from happening again by using benzoyl peroxide wash and/or applying mupirocin and retapamulin ointment to the nostrils.
Examine family members for symptoms of impetigo and urge all those in close proximity to cleanse their hands with ethanol or isopropyl gel. Treatment using antibiotics that act throughout the body.