Impetigo
Revision as of 01:00, 24 February 2015 by Rossdonaldson1 (talk | contribs) (→Differential Diagnosis)
Background
- Superficial epidermal infection characterized by amber crusts (nonbullous) or vesicles (bullous)
- May be super-infection or primary infection
- Typical causative organisms are Staphylococcus aureus or Streptococcus pyogenes
- Fever and systemic signs are uncommon
- Postinfectious Glomerulonephritis is a possible complication
Diagnosis
- Nonbullous
- Erythematous macules/papules develop into vesicles which become pustular and rupture
- As rupture release yellow fluid which dries to form stratified golden crust
- Erythematous macules/papules develop into vesicles which become pustular and rupture
- Bullous
- Bullae form as result of staph toxin
- Some cases caused by MRSA
Work-up
- Clinical diagnosis
Differential Diagnosis
Other Rash
- Acute generalized exanthematous pustulosis
- Allergic reaction
- Aphthous stomatitis
- Atopic dermatitis
- Coxsackie
- Dermatitis herpetiformis
- Exfoliative erythroderma
- Impetigo
- Pellagra
- Pityriasis rosea
- Serum Sickness
- Tinea capitus
- Tinea corporis
- Vitiligo
Treatment
- Topical antibiotics
- Mupirocin ointment 2% TID x 7-14d
- Oral antibiotics
- Consider for large areas or if topical treatment is impractical or for bullous impetigo
- Clindamycin 24mg/kg/d in 3 doses x7-10d