Page 22 - LECTURE NOTES

Lesions develop on either normal or traumatized skin or are superimposed on a

preexisting skin condition (e.g., scabies, varicella, atopic dermatitis).
Lesions are located at exposed parts of the body (e.g., scalp, arms, legs), sparing the

palms and soles. Localized lymphadenopathy usually is present, and nodes may be
tender.

Bullous impetigo:
The characteristic lesion is a vesicle that develops into a superficial flaccid bulla on

intact skin, with minimal or no surrounding redness. Initially, the vesicle contains clear
fluid that becomes turbid.

The roof of the bulla ruptures, often leaving a peripheral collarette of scale if removed;

it reveals a moist red base.

Management
Local management for small lesions: - Wash with betadine solution or saline.

Potassium permanganate 1 in 1000 solution soaking twice a day until the pus
exudates dry up.

Gentian violet (GV) paint 0.5% apply BID.

Topical antibiotics can be used, such as 2% mupirocin, Gentamycine, Fucidic acid can
be used but costly.

Systemic treatment: - for impetigo contagiosa, a single dose of benzathin penicillin
coupled with local care.

Oral amoxacyllin or Ampicillin can also be used.
For Bullous impetigo: - cloxacillin 500 mg po QID for 7 to 10 days. In cases, with an

allergy to penicillin, erythromycin can be given.

The underlining skin conditions such as eczemas, scabies, fungal infection, or
pediculosis should be treated.

When impetigo is neglected it becomes ecthyma, a superficial infection which involves

the upper dermis which may heal forming a scar..

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