Impetigo is a common, contagious, superficial skin infection that is produced by bacteria. The two most common bacteria that cause impetigo are streptococcus and staphylococcus. This infection is more common in children than in adults. If not appropriately treated more serious complications may arise.
The most common form of impetigo is called bullous (blistering) impetigo and derives its name from the initial presentation of one or more rapidly enlarging flaccid blisters. These blisters are typically filled with a yellow or cloudy liquid and easily rupture giving way to red erosions that are ultimately covered by a characteristic yellow or "honey-crusted” scab. Another form known as nonbullous (nonblistering) impetigo appears to be a secondary infection. Some minor injury to the skin such as a cut or insect bite allows the bacteria to enter otherwise intact skin. Typically multiple pustules will erupt, merge together, rupture, and then form the characteristic red erosion with "honey-crusted” scab.
Many cases of impetigo can be prevented by the application of antibiotic ointments to areas of minor skin trauma. Left untreated impetigo may resolve on its own, however, it may continue to spread. A topical prescription medication known as Bactroban (mupirocin) is an effective treatment. Crusts should be removed by soaking and the base treated with Bactroban three times per day until the lesions have resolved. Another effective topical ointment is Altabax (retapamulin), which is applied two times a day. Oral antibiotics directed against the most common bacteria are effective and may also be prescribed. Patients who get recurrent impetigo should be evaluated for the carriage of the causative bacteria. The most common reservoir is the nose. Bactroban may be applied to the nostrils in an attempt to eradicate the bacteria.
When properly treated, the lesions of impetigo heal with little to no scarring. In addition prompt, effective treatment diminishes the chances of serious secondary complications that could affect the kidneys, joints, bones, and lungs.
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