Impetigo: Its Types, Causes, Risk Factors, Symptoms And Treatment

Impetigo is a superficial skin infection that occurs in nonbullous and bullous (elevated lesions) forms. Beta-hemolytic streptococcus usually produces nonbullous impetigo. Coagulase-positive staphylococcus aureus usually causes bullous impetigo.Impetigo is one of the most common skin infections in children. It can occur in adults but is seen far more often in children. Impetigo is contagious and can be spread to others through close contact or by sharing towels, sheets, clothing, toys, or other items. Scratching can also spread the sores to other parts of the body.

Types of Impetigo:

There are three types of impetigo:

1. bullous impetigo – which causes large, painless, fluid-filled blisters.
2. non-bullous impetigo – which is more contagious than bullous impetigo and causes sores that quickly rupture (burst) to leave a yellow-brown crust.
3. Ecthyma – This more serious form of impetigo penetrates deeper into the skin’s second layer (dermis).

Impetigo can also be classed as:

• primary – where bacteria enters skin that is otherwise healthy – for example, through a cut or wound.
• secondary – where the infection is the result of another underlying cause, such as atopic eczema.

1. Impetigo contagiosa: It also known as nonbullous impetigo. The most common form of impetigo is impetigo contagiosa, which usually starts as a red sore on your child’s face, most often around the nose and mouth. The sore ruptures quickly, oozing either fluid or pus that forms a honey-colored crust. Eventually the crust disappears, leaving a red mark that heals without scarring. Impetigo sores may be itchy, but they aren’t painful. Your child isn’t likely to have a fever with this type of impetigo but may have swollen lymph nodes in the affected area. And because it’s highly contagious, just touching or scratching the sores can spread the infection to other parts of the body.
2. Bullous impetigo:  This type primarily affects infants and children younger than 2 years. It causes painless, fluid-filled blisters — usually on the trunk, arms and legs. The skin around the blister is usually red and itchy but not sore. The blisters, which break and scab over with a yellow-colored crust, may be large or small, and may last longer than sores from other types of impetigo.
3. Ecthyma: This more serious form of impetigo penetrates deeper into the skin’s second layer (dermis). Signs and symptoms include painful fluid- or pus-filled sores that turn into deep ulcers, usually on the legs and feet. The sores break open and scab over with a hard, thick, gray-yellow crust. Scars can remain after the sores heal. Ecthyma can also cause swollen lymph nodes in the affected area.

Causes And Risk Factors of Impetigo:

Impetigo is caused by one or both of the following types of bacteria:

• Group A Streptococcus
• Staphylococcus

These bacteria are normally found on the skin and in the nose. When small cuts, scratches, or insect bites occur, these bacteria can get under the skin. There they can cause infection. Impetigo is often spread from person to person.

Factors that increase your chance for impetigo include:

• Age: preschool and school-aged children
• Touching a person with impetigo
• Touching the clothing, towels, sheets, or other items of a person with impetigo
• Poor hygiene, particularly unwashed hands and dirty fingernails
• Crowded settings where there is direct person-to-person contact, such as schools and the military
• Warm, humid environment
• Seasonal: Summer
• Poor health or weakened immune system
• Tendency to have skin problems such as Eczema, Poison Ivy, Poison Oak, Poison Sumac, or skin allergy
• Cuts, scratches, Insect Bites and Stings , or other injury or trauma to the skin
• Chickenpox
• Lice infections

Symptoms of Impetigo:

• A single or possibly many blisters filled with pus; easy to pop and — when broken — leave a reddish raw-looking base (in infants)
• Itching blister:
  1. Filled with yellow or honey-colored fluid
  2. Oozing and crusting over
• Rash — may begin as a single spot, but if person scratches, it may spread to other areas
• Skin lesions on the face, lips, arms, or legs, that spread to other areas
• Swollen lymph nodes near the infection (lymphadenopathy)

Treatment of Impetigo:

The key to treating  and preventing to impetigo is good personal hygiene and a clean environment. Once the infection occurs, prompt attention will keep it under control and prevent its spread.

Treatments include:

• Hygienic measures: Sometimes your doctor may choose to treat minor cases of impetigo with only hygienic measures. Keeping the skin clean can help mild infections heal on their own.
• Topical antibiotics: Your doctor may prescribe a prescription antibiotic that you apply to the affected areas (topical antibiotic), such as the ointments mupirocin (Bactroban) or retapamulin (Altabax). Before applying the antibiotic, you need to gently remove any scabs so that the antibiotic can penetrate the sore.
• Oral antibiotics: Antibiotics you take by mouth (oral antibiotics) may be prescribed for widespread impetigo, ecthyma and severe cases of impetigo contagiosa. The specific antibiotic depends on the severity of the infection and any known allergies or medical conditions. Be sure to finish the entire course of medication even if the sores are healed. This helps prevent the infection from recurring and makes antibiotic resistance less likely.