Impetigo Symptoms And Treatment

What is impetigo?

Impetigo is usually fairly harmless, but contagious, infectious disease caused by bacteria. In 80% of cases, Staphylococcus aureus is the culprit, in 10% of cases, Streptococcus pyogenes, and in another 10% of cases, both of them at the same time. The incubation period is 1 to 3 days.

Impetigo symptoms

Impetigo is a skin rash that often in the face or neck down, but can occur anywhere on the body, from the scalp to the soles. Initially arise bumps that quickly change into blisters that burst and which then pretty much moisture flows that solidifies into honey-yellow translucent crusts. This yellowish view argues more for S. aureus pathogen than other potential pathogens. Normally someone has no pain with this condition (as distinguished from a superinfection with herpes zoster is possible).

Sometimes it can also occur blisters with clear fluid ( bullous impetigo ). In places where the epidermis is thick (soles of the feet, hand palms) may be this large blisters, which extend easily by pressure. Piercing and remove blaardak stops blister expansion and makes it accessible for wound ointment treatment.

Blistering
Some strains of S. aureus have exfoliative toxins (ET). The types of ET-A and ET-B appear to be able to break down desmoglein, which is a part of the desmosome which the skin cells of the epidermis connects with each other. This causes the blisters, which sometimes occurs with impetigo (impetigo bullosa). If the toxins are spread blistering may occur in places where there is no bacteria or inflammation. This is staphylococcal scalded skin syndrome (SSSS) mentioned.

Spread

Many people carry the bacteria in their nose or throat with him without being sick. The bacteria can be spread by coughing and sneezing. By scratching and picking one gets the bacteria to the fingers and can easily infect themselves in other places or other people. Infection occurs through direct contact. Through direct contact or through touching as toys other children infected. This can also occur through clothing or towels. Hygiene is a good way to prevent spreading, frequent hand washing is recommended. As long as the vesicles secrete fluids, the patient remains contagious.

Incidence

Impetigo can occur at any age but is obviously much more common in children, often between 2 and 12 years. Adults have been a certain resistance developed. Yet there is no complete immunity. A person infection can therefore go through several times during his life.

The number of outbreaks of impetigo has quadrupled in ten years. The disease has also become more severe and difficult to treat than before.

Impetigo treatment

The best remedy for impetigo is not scratch the blisters, which by the uncommon itching can be a problem. To reduce the itching may zinc ointment (zinc oxide) to help the affected area, which has the added advantage that the blisters dry up faster. Impetigo usually heals with the drying itself.

The cure is strongly accelerated by the local application of (a cream or ointment) antibiotics. Usually, in the first instance, the practitioner will have a cream with, for example fusidic or tetracycline prescribe that the risk of infection is gone within 48 hours. Children with impetigo can thus 48 hours after treatment back to school, except when they are sick and listless from his. The ointment works best when the blisters or sores are open and the active substance can reach the bacteria. It is therefore of great importance to remove the thin skin on the blisters for the application of the ointment; in places where the skin is thin this may be the easiest there once vigorous rubbing with a rough, damp washcloth. This is, in general, hardly painful. On the soles and the like, where the blister skin is thick will need to work with scissors and forceps. If ointment tetracycline or fusidic not help enough can be prescribed an ointment mupirocin. Sometimes it is also prescribed to hormonal an ointment basis such as hydrocortisone.

In extensive cases may (also) a course of oral antibiotics such as flucloxacillin are given, but because with careful local treatment with ointment healing usually occurs rapidly certainly not a first choice. When flucloxacillin no or insufficient result than amoxicillin may be prescribed. This antibiotic may be prescribed alone or in combination with clavulanic acid. This combination is also known as Augmentin put on the market. Clavulanic acid covers a 2nd group of bacteria and thereby Augmentin is regarded as a broad spectrum antibiotic.

The use of disinfectants such as chlorhexidine and povidone-iodine is apparently less effective than antibiotics, such as is also evident from research.