What is Impetigo ?

What is Impetigo ?
Impetigo is the most common skin infection seen in children which is contagious and characterized by blisters or sores on hands and face. The name Impetigo is derived from impetere assail and is also known as school sores. This infection is caused by bacterium streptococcus pyogens which is also known as Group A beta-hemolytic streptococci (GABS). The infection can be caused by mixture of two organisms. It is usually developed when the skin is already damaged or injured due to any skin problems. It can also develop due to skin allergies related to soaps and cosmetics. It occurs mostly during summer season.

Causes
Impetigo is basically caused by bacterium Staphylococcus aureus. These bacteria live on the human skin without harming until it gets deeper into the skin through cuts to cause infection. Two types of impetigo are most commonly seen: one is the primary impetigo and the other secondary impetigo. Impetigo that affects the normal skin is primary impetigo and the one which affects the skin through insect bites or cuts fall under secondary impetigo. In adults, mostly impetigo occurs due to the injury on the skin or other skin conditions such as dermatitis. In children it can occur through cuts or without any skin damage. The infection spreads with direct skin to skin contact especially in schools, day to day cares and crowded areas. It is more common to occur in summer season.

Signs and Symptoms It is seen as tiny blisters and can occur anywhere in the body but usually seen in places like mouth, nose, forearms and hands. The blisters expand and ultimately burst within 24 hours and leave the skin red with small wet patches. The patches tend to weep fluid. The fluids that is yellowish in colour drains and dries to form a honey-coloured crust. The cuts are seen with ruptured bullae and edges. The other common symptoms seen in people affected with impetigo include fever, diarrhea and weakness or tiredness. The infected person will have the tendency to itch and it can even spread due to scratching. It basically spreads with direct skin to skin contact. So anyone who comes in contacted with the infected skin or with other items used by the infected person such as towels, bed spreads can also get infected.

Types
Depending on the signs and symptoms there are different kinds of Impetigo:
• Bullous Impetigo.
• Ecthyma.
• Impetigo contagiosa.

Bullous Impetigo It is characterized by blisters which is usually painless and appears mostly on legs, arms and trunk. These blisters last longer compared to blisters of other types of Impetigo. They are affected in children with the age group less than two years and can be seen even in infants. The symptoms of Bullous Impetigo include weakness, diarrhea and fever.

Ecthyma This is the serious form of Impetigo wherein the infection spreads deep into the skin’s layer.
The symptoms of Ecthyma are :
The pus which drains out of the lesion is dried to form gray-yellow crust.
Swollen lymph glands appear in the affected region of the skin. Sores appear on legs and feet which are painful and filled with pus. They turn to ulcers in later stages. Scars remain after the ulcers are healed.

Impetigo contagiosa It is the most common type of Impetigo. It is usually seen on the child’s face especially around the nose and mouth. The sores are not painful but are found to be itchy. The affected areas have swollen lymph nodes and scratching the sores will spread the infection to other parts of the body. It is less common to develop fever for this type.

Treatments
Impetigo is generally diagnosed by antibiotics or skin ointments. The treatment may vary depending on the age and also the type of infection. If it is just the starting stage where the infection is not spread then it is recommended using a skin cream but if the infection is spread then the doctor’s give antibiotics. The skin ointments used are fusidic acid or mupirocin and the antibiotics include flucloxacillin or erythromycin. Cleanliness can prevent the infection from spreading to other parts of the body. If the condition is minor then the treatments are simpler such as cleaning the infected skin and keeping it free from bacteria. The treatment may involve just washing with soap and water and letting the infection (impetigo) dry in air. This may heal the disease soon without using any antibiotics. In other cases doctors may prescribe topical antibiotics or oral antibiotics. Oral antibiotics are given in serious cases of Impetigo. Topical antibiotics avoid side effects such as diarrhoea which are likely in oral antibiotics. The patients are advised to complete the entire course of treatment to become antibiotic resistant. Early and proper treatment will avoid the scarring of skin and spreading of infections to other areas. The other method of preventing the infection from spreading to other parts of the body is to keep the infected areas of the skin covered with tape or loose bandage. Children should keep their fingers nails short and clean.

Prevention
Keeping oneself hygiene or having good hygiene practices is the best way to prevent diseases like impetigo. Cuts, wounds, insect bites etc must be treated immediately to prevent the infection. Regular washing of the wounds and keeping them covered will help a lot. If anyone in the family is affected with impetigo it is important to take treatment as fast as possible and the items used by the infected person such as towels, combs, bed linens should not be shared with anyone else in the family. Gloves must be used while applying creams to the infected portion and hands must be washed with antibacterial soaps. Nails must be cut short and clean to avoid scratching and spreading of infection. If children are affected with impetigo it is better not to send them to school until the treatment is over or doctor advises to do so.

Complications
Even though the disease does not look like dangerous there are certain complications which occur due to impetigo.
The serious complications include the following:

Article Contributed By: Shilpa V

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