Overview
What are the signs and symptoms of nonbullous impetigo?
What are the signs and symptoms of bullous impetigo?
Who is most likely to contract impetigo?
What are the types of impetigo and which is most common?
Which form of impetigo is most common in children?
What causes nonbullous impetigo?
Can impetigo progress to systemic infection?
How does impetigo present in hair follicles?
How is impetigo diagnosed and what is the treatment?
How does skin disruption affect risk of infection in impetigo?
Which types of skin disruption facilitate bacterial infection in impetigo?
Does immunosuppression affect the risk of bacterial infection in impetigo?
Can impetigo occur in intact skin?
Is impetigo or group A beta hemolytic streptococcal (GABHS) skin infection contagious?
How common is S aureus colonization and where does it occur?
What is the role of exotoxins in bullous impetigo?
How is community-acquired MRSA differentiated from hospital-acquired MRSA?
Which bacteria cause impetigo?
Which bacteria cause nonbullous impetigo?
Which bacteria cause bullous impetigo?
What is the prevalence of impetigo in the US?
What is the international prevalence of impetigo?
How does the incidence of impetigo differ among demographics?
How long does it take for impetigo to heal?
What are the complications of impetigo and how common are they?
What is acute poststreptococcal glomerulonephritis (APSGN) and how common is it in impetigo?
What information on impetigo should be provided to patients or their parents?
Presentation
How is the onset and initial progression of nonbullous impetigo characterized?
How is the onset and initial progression of bullous impetigo characterized?
Which environmental factors are associated with impetigo?
What is the relationship between immunoglobulin deficiencies and impetigo?
Which symptoms are associated with bullous impetigo but not impetigo contagiosa?
What are the typical physical exam findings in bullous impetigo?
What are the typical physical exam findings in impetigo?
What are the typical physical exam findings in nonbullous impetigo?
What are the potential complications of impetigo?
DDX
How is impetigo differentiated from tinea?
How is impetigo differentiated from herpetic impetigo?
How is impetigo differentiated from pemphigus vulgaris?
How is impetigo differentiated from follicular mucinosis?
How is impetigo differentiated from erysipelas?
How is impetigo differentiated from insect bites?
What are the differential diagnoses for Impetigo?
Workup
When is bacterial culture and sensitivity testing indicated in the workup of impetigo?
Which lab testing is indicated in the workup of nonbullous impetigo?
Which test is used to confirm recent streptococcal skin infection in impetigo-associated APSGN?
When is urinalysis indicated in the workup of impetigo?
What is the role of a potassium hydroxide wet mount or Tzanck preparation in the workup of impetigo?
What is the role of a bacterial culture in the workup of impetigo?
When are serum IgM levels indicated in the workup of impetigo?
What are the histologic findings in bullous impetigo?
What are the histologic findings in nonbullous impetigo?
Treatment
What are the roles of wound care and hygiene in the treatment of impetigo?
How are antibiotics used in the treatment of impetigo?
How is community-acquired MRSA impetigo treated?
How are topical and systemic antibiotics used in the treatment of impetigo?
When does impetigo require hospitalization and how is it treated?
How are topical antibiotics used in the treatment of impetigo?
How is mupirocin used in the treatment of impetigo?
How is retapamulin used in the treatment of impetigo?
How is fusidic acid used in the treatment of impetigo?
What are the second-line topical antibiotics used in the treatment of impetigo?
What is the role of ozenoxacin in the treatment of impetigo?
When is systemic antibiotic therapy indicated in the treatment of impetigo?
Which systemic antibiotics are recommended for the treatment of impetigo?
Which antibiotics are used in the treatment of MRSA impetigo?
When can children with impetigo return to school or day care?
How is impetigo prevented in a patient's household members or other close contacts?
How does impetigo treatment prevent transmission?
What is the role of personal hygiene in the prevention of impetigo?
What is the treatment for recurrent impetigo?
What is the role of polymerase chain reaction in screening for MRSA impetigo?
Is mass treatment effective for the prevention of scabies and impetigo?
When is consultation indicated in impetigo?
What follow-up is indicated in the treatment of impetigo?
Medications
Which medications are used in the treatment of impetigo?
What are the advantages and disadvantages of topical antibiotics in the treatment of impetigo?
When is systemic antibiotic therapy indicated in impetigo?
Which medications are indicated in the treatment of MRSA impetigo?
Which medications in the drug class Antibiotics, Other are used in the treatment of Impetigo?
Which medications in the drug class Topical Antimicrobials are used in the treatment of Impetigo?
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Bullous impetigo with circumscribed lesions with a thin collarette of scale.
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Bullous impetigo on the buttocks. Courtesy of Medical University of South Carolina, Department of Dermatology.
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Following dermabrasion, this patient developed nonbullous impetigo in the same area as several herpes simplex lesions. Note the grouped vesicles which are classic for herpetic lesions, as well as additional crusted pink plaques. Concurrent bacterial impetigo can often be seen with herpes simplex and aerobic bacterial cultures are important to identify secondary impetigo.
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A nummular eczema lesion on the knee, impetiginized with Staphylococcus aureus.