Impetigo

• What is impetigo?

  Common superficial bacterial skin infection
• What percentage of impetigo cases are non-bullous?

  Approximately 70%
• Which bacteria commonly cause non-bullous impetigo?

  Staphylococcus aureus and Streptococcus pyogenes
• What percentage of impetigo cases are bullous?

  Approximately 30%
• How is impetigo transmitted?

  Direct contact with infected skin, sharing toys, impacted skin
• What is the incubation period for impetigo?

  4 to 10 days
• What is the typical duration for untreated impetigo to resolve?

  2 to 3 weeks
• In which age group is impetigo more common?

  Children aged 0-4 years
• What are the common symptoms of bullous impetigo?

  Fluid filled vesicles and blisters without redness, fever
• What happens to bullous impetigo blisters after they rupture?

  They leave a thin, flat, yellow/brown crust
• Where are bullous impetigo lesions most commonly found?

  On flexures, face, trunk, and limbs
• What systemic symptoms can occur if bullous impetigo is widespread?

  Fever
• What may develop following autoinoculation in non-bullous impetigo?

  Satellite lesions
• What characterizes non-bullous impetigo lesions?

  Thin-walled vesicles or pustules forming crusts
• Where are non-bullous impetigo lesions most commonly located?

  On exposed skin of the face and limbs
• What symptoms may accompany non-bullous impetigo?

  Mild itchiness or pain
• Are systemic symptoms common in non-bullous impetigo?

  No, they are uncommon
• What is the first-line treatment for localized impetigo?

  Hydrogen peroxide 1% cream
• What topical antibiotics can be used if hydrogen peroxide is unsuitable?

  Fusidic acid 2% or Mupirocin 2%
• What is the treatment for widespread impetigo?

  Short course of topical or oral antibiotics
• What factors influence the choice of antibiotic for widespread impetigo?

  Patient preference and antibiotic resistance risk
• What is the recommended oral antibiotic for widespread impetigo?

  Flucloxacillin
• What should be done if a patient is penicillin-allergic?

  Use Clarithromycin or Erythromycin
• What should be done for recurrent bullous impetigo?

  Send skin and nasal swabs to microbiology
• What practical measures should be taken to manage impetigo?

  • Wash affected areas with soap and water
  • Wash hands regularly after touching lesions
  • Avoid scratching affected areas
  • Cover patches with loose clothing or gauze
  • Avoid sharing personal care products
  • Wash contaminated toys and play equipment
  • Wash linens at high temperature
  • Stay away from school/nursery until healed
  • Inform employers if a food handler has impetigo
  • Treat pre-existing skin conditions
  • Avoid contact with immunocompromised individuals
• How long should children stay away from school with impetigo?

  Until lesions are healed or 48 hours after treatment
• What is required by law for food handlers with impetigo?

  To inform their employers immediately
• Why is it important to treat pre-existing skin conditions in impetigo patients?

  To prevent exacerbation of impetigo
• Who should be avoided in contact with impetigo patients?

  Immunocompromised individuals, pregnant women, infants