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Impetigo

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Definition

Impetigo is a bacterial infection of the superficial layers of the skin. These characteristic leisions appear on the face, mainly around nose and mouth but they can be present on other parts of the body like arms, legs and trunk. These leisions are red in color, may ooze and form dark brown crusts over them. This is a highly contagious skin infection. It can occur on skin with breaks on it which may be caused by an insect bite, animal or human bite or a small cut. Impetigo can also occur on skin where there is no visible break.

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Types

  • Impetigo contagiosa
  • Bullous impetigo
  • Ecthyma

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Causes

  • Impetigo is caused by Streptococcus pyogenes or Staphylococcus aureus.
  • It usually follows other skin disorders or a recent upper respiratory infection such as a cold or other viral infection.

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Symptoms

  • Impetigo contagiosa
    • Itchy, red sore on the face that are not painful
    • The sore ruptures oozing either fluid or pus that forms a dark brown crust over it.
    • Swollen lymph nodes in the neck on the affected side
  • Bullous impetigo
    • Painless blisters
    • Fever
    • Diarrhea
    • Generalized weakness
  • Ecthyma
    • Painful fluid or pus-filled sores that turn into deep ulcers, usually on the legs and feet
    • A hard, thick, crust covering the sores
    • Swollen lymph glands in the affected area
    • Remnant scars after the ulcers heal

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Implications

Impetigo is not dangerous in itself however, it may lead to other problems if the infection spreads systemically. This may lead to a condition called post-streptococcal glomerulonephritis (kidney inflammation). The inflammation of kidney occurs when the debris from dead bacterial and antibodies gets trapped in the tubules, causing damage to the kidney tissue, hampering it's function to remove the waste products from the body and eventually leading to kidney. Timely treatment of streptococcal skin and throat infection can clear the infection but it cannot prevent the kidney inflammation from occurring. Untreated Impetigo can progress to cellulitis and involve the deeper tissues of skin causing skin damage and scarring. In rare cases, it can prove to be life threatening. Meningitis or inflammation of the fluids and membranes that surround the brain is another serious or sometimes fatal complication of serious and extensive skin infection.

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What You Can Do

  • Medications
    • Oral antibiotics like erythromycin or dicloxacillin may rapidly clear the infection
    • Topical antibiotic applications in the form of creams such as Bactroban.
  • General Hygiene
    • Wash the affected parts of the skin with an antibacterial soap and water to soften and remove the crusts
    • Soak the affected areas of skin in a vinegar solution in water for 20 minutes. This makes it easier to gently remove the scabs.
    • Apply an antibiotic ointment three or four times daily after washing and patting it dry.
    • Avoid scratching or touching the sores.
    • Wear disposable gloves while applying ointment to the affected skin areas.
    • Applying a non-stick dressing to the infected area to help keep the infection from spreading.
    • Use a clean washcloth and towel each time you bathe or take a shower.
    • Wash the clothing and items of personal use of the affected person separately from rest of the family members.
    • The clothing should be washed in hot water and preferably air dried.
    • Do not share items of personal use like towels, clothing, razors etc.
    • Wash the hands thoroughly after touching the skin lesions.
  • Prevention
    • Minor cuts, abrasions or areas of damaged skin should be thoroughly cleansed with soap and clean water.
    • A mild topical antibacterial cream or ointment should be applied to prevent infection.
    • Avoid direct skin contact with people affected with impetigo.

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Impetigo