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SKIN DISEASES: Ordinary and Bullous Impetigo

Dermatlas: Bullous impetigo
Bullous impetigo

© 2001-05, Dermatlas

Location: most frequently lesions appear on the face (around the mouth and the nose) or at a site of trauma. Impetigo is a very superficial skin infection not involving the skin's deeper layers.

Symptoms: Impetigo occurs more commonly in children. Impetigo has two general forms: ordinary impetigo and bullous impetigo. The majority (90%) of bullous impetigo cases occur in children younger than 2 years.

Ordinary impetigo - is scabby and pustular (little pimples full of pus) in appearance and is generally caused by streptococcal germs. It starts as a small blister or pustule that ruptures and leaves a reddish base which is then covered by a honey-colored crust. In children, this condition often begins on the skin near the nose, though it may spread. Ordinary impetigo is also known as impetigo vulgaris and streptococcal impetigo.

Bullous impetigo - produces large, fragile blisters and is caused mostly by staph germs. It also often affects the face, but may appear elsewhere. The blisters it forms have very thin walls that collapse, leaving a bright red, inflamed, moist base. Bullous impetigo is also known as impetigo bullosa and staphylococcal impetigo.

Treatments: Oral antibiotics, including derivatives of penicillin, erythromycin, and cephalexin that are given for 7 to 10 days will generally clear up impetigo. A prescription of a strong topical antibiotic, such as mupirocin (Bactroban), is also very safe and effective. Its use often makes oral treatment unnecessary. Over-the-counter topical antibiotics like bacitracin or Neosporin (which contains bacitracin) do not seem to be much more effective than applying petroleum jelly or nothing at all. When they do seem to work, it is often because the condition was not infected to begin with.

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