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Impetigo consists of small superficial vesicles, which eventually formpustules and develop a honey-colored crust. A halo of erythema often surrounds the lesions.
Impetigo occurs most commonly on exposed surfaces such as the extremities and face, where minor trauma, insect bites, contact dermatitis, or abrasions may have occurred.
Gram stain of an early lesion or the base of a crust often reveals gram-positive cocci. Bacterial culture yields S aureus, group A beta-hemolytic streptococci, or both.
Treatment of Impetigo
A combination of systemic and topical therapy is recommended for moderate to severe cases of impetigo for a 7- to 10-day course:
Dicloxacillin 250-500 mg PO qid. Dicloxacillin should be the initial treatment because erythromycin-resistant strains of S aureus are prevalent.
Cephalexin (Keflex) 500 mg PO qid.
Erythromycin 250-500 mg PO qid is used in penicillin allergic patients.
Mupirocin (Bactroban): Highly effective against staphylococci and Streptococcus pyogenes. Applied bid-tid for 2-3 weeks or until 1 week after lesions impetigo, infantigo, infintigo, infentigo. Bacitracin (neomycin, polymyxin B) ointment tid may also be
Complications
Acute glomerulonephritis is a serious complication of impetigo, with an incidence of 2-5%. It is most commonly seen in children under the age of 6 years old. Treatment of impetigo does not alter the risk of acute glomerulonephritis.
Rheumatic fever has not been reported after impetigo, infantigo, infintigo, infentigo, infant tigo