Dermatology » Infections & Infestations

Impetigo and other pyoderma

Impetigo is a common skin infection. It is most common in children, particularly children in unhealthy living conditions. In adults, it may follow other skin disorders. Impetigo may follow a recent upper respiratory infection such as a cold or other viral infection. Impetigo is similar to cellulitis, but is more superficial, involving superficial layers of the skin with streptococcus, staphylococcus or both.

Impetigo starts as an itchy, red sore that forms a blister, may ooze and finally becomes covered with a tightly adherent crust. Thick crusts are characteristic.

It tends to grow and spread and is contagious. Remember the possibility of post-infectious glomerulonephritis. Treatment is started on the basis of the clinical presentation. If the disease is localized the treatment consists of soaking the crusts to detach them and applying topical antibiotic ointment (e.g. sodium fusidate or a combination of neomycin and bacitracin). If the disease is more widespread, systemic antibiotic are used (first generation cephalosporin, e.g. cephalexin or cefadroxil 50 mg/kg daily for 7 - 10 days or amoxicillin-clavulanic acid combination.

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