Impetigo
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Impetigo is a
It is typically due to either
Prevention is by
Impetigo affected about 140 million people (2% of the world population) in 2010.
Signs and symptoms
Contagious impetigo
This most common form of impetigo, also called nonbullous impetigo, most often begins as a red sore near the nose or mouth which soon breaks, leaking pus or fluid, and forms a honey-colored scab,[11] followed by a red mark which often heals without leaving a scar. Sores are not painful, but they may be itchy. Lymph nodes in the affected area may be swollen, but fever is rare. Touching or scratching the sores may easily spread the infection to other parts of the body.[12]
Skin ulcers with redness and scarring also may result from scratching or abrading the skin.[citation needed]
Bullous impetigo
Bullous impetigo, mainly seen in children younger than two years, involves painless, fluid-filled blisters, mostly on the arms, legs, and trunk, surrounded by red and itchy (but not sore) skin. The blisters may be large or small. After they break, they form yellow scabs.[12]
Ecthyma
Ecthyma, the nonbullous form of impetigo, produces painful fluid- or pus-filled sores with redness of skin, usually on the arms and legs, become ulcers that penetrate deeper into the dermis. After they break open, they form hard, thick, gray-yellow scabs, which sometimes leave scars. Ecthyma may be accompanied by swollen lymph nodes in the affected area.[12]
Causes
Impetigo is primarily caused by
Predisposing factors
Impetigo is more likely to infect children ages 2–5, especially those that attend school or day care.[3][15][1] 70% of cases are the nonbullous form and 30% are the bullous form.[3] Impetigo occurs more frequently among people who live in warm climates.[16]
Transmission
The infection is spread by direct contact with lesions or with nasal carriers. The incubation period is 1–3 days after exposure to Streptococcus and 4–10 days for Staphylococcus.[17] Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.[citation needed]
Diagnosis
Impetigo is usually diagnosed based on its appearance. It generally appears as honey-colored scabs formed from dried sebum and is often found on the arms, legs, or face.[13] If a visual diagnosis is unclear a culture may be done to test for resistant bacteria.[18]
Differential diagnosis
Other conditions that can result in symptoms similar to the common form include
Other conditions that can result in symptoms similar to the blistering form include other
Prevention
To prevent the spread of impetigo the skin and any open wounds should be kept clean and covered. Care should be taken to keep fluids from an infected person away from the skin of a non-infected person. Washing hands, linens, and affected areas will lower the likelihood of contact with infected fluids. Scratching can spread the sores; keeping nails short will reduce the chances of spreading. Infected people should avoid contact with others and eliminate sharing of clothing or linens.[19] Children with impetigo can return to school 24 hours after starting antibiotic therapy as long as their draining lesions are covered.[20]
Treatment
More severe cases require oral antibiotics, such as
Alternative medicine
There is not enough evidence to recommend alternative medicine such as tea tree oil or honey.[3]
Prognosis
Without treatment, individuals with impetigo typically get better within three weeks.
Epidemiology
Globally, impetigo affects more than 162 million children in low- to middle-income countries.[25] The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania.[25] The tropical climate and high population in lower socioeconomic regions contribute to these high rates.[26] Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old.[27] As age increases, the rate of impetigo declines, but all ages are still susceptible.[26]
History
Impetigo was originally described and differentiated by the English
References
- ^ a b c "Impetigo - school sores". Bettel Health Channel. Archived from the original on 5 July 2017. Retrieved 10 May 2017.
- ^ S2CID 29798971.
- ^ PMID 25250996.
- ^ S2CID 34948265.
- ^ PMID 22258953.
- ^ PMID 23245607.
- ^ ISBN 978-0-323-71159-3.
- ^ "Impetigo symptoms and treatments". www.nhsinform.scot. Retrieved 2020-05-26.
- ^ "Impetigo and Ecthyma - Skin Disorders". Merck Manuals Consumer Version. Retrieved 2020-05-26.
- ISBN 978-1-84022-497-9. Archivedfrom the original on 2016-10-03.
- from the original on 2015-04-30.
- ^ a b c Mayo Clinic staff (5 October 2010). "Impetigo". Mayo Clinic Health Information. Mayo Clinic. Archived from the original on 28 November 2012. Retrieved 25 August 2012.
- ^ ISBN 978-1-4160-2973-1.
- from the original on 2007-09-29.
- ^ "Impetigo (school sores)". www.health.govt.nz. Ministry of Health. Retrieved 14 September 2017.
- ISBN 978-0-8036-2505-1.
- ^ "ISDH: Impetigo". state.in.us. Archived from the original on 11 December 2014. Retrieved 11 December 2014.
- ^ "Impetigo: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 2016-11-07.
- ^ "Self-management - Impetigo - Mayo Clinic". www.mayoclinic.org. Archived from the original on 16 October 2016. Retrieved 7 October 2016.
- ^ a b c Baddour L. "Impetigo". UpToDate. Retrieved 2018-08-15.
- ISBN 978-1-60547-159-4. Archivedfrom the original on 2017-09-08.
- ^ "Impetigo: antimicrobial prescribing - NICE guideline [NG153]". www.nice.org.uk. 26 February 2020. Retrieved 2020-05-26.
- S2CID 201018620.
- ^ "Valacyclovir Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 17 March 2019.
- ^ PMID 26317533.
- ^ PMID 26088526.
- PMID 12939895.
- S2CID 214846855.
- ISBN 978-0-06-270084-1.
- PMID 15499130.
- ^ Tilbury Fox W (1864). On impetigo contagiosa, or porrigo. England: Printed by T. Richards.
External links
- Impetigo at Curlie
- Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition
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