Impetigo (bullous)

Diagnosis: Impetigo (bullous)

Thin-wall bullae that easily rupture and form erosions.

Clinical Presentation

Thin-wall bullae that easily rupture and form erosions.

Clinical History

Submitted by Alaa Saad. Originally posted September 21, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Herpes simplex • Contact dermatitis • Tinea corporis/faciei • Bullous pemphigoid (bullous impetigo) • Ecthyma • Varicella • Insect bites with secondary infection

Key Learnings

• Two forms: non-bullous (~70%, typically Staph or Strep) and bullous (Staph aureus exfoliative toxins) • Honey-colored crusts are characteristic of non-bullous impetigo • Bullous impetigo: S. aureus exfoliative toxin A/B → localized form of SSSS • Highly contagious — spread by direct contact • Poststreptococcal glomerulonephritis is a rare but important complication of streptococcal impetigo • Unlike pharyngitis, cutaneous strep does not cause rheumatic fever • MRSA impetigo increasingly common — culture if treatment-resistant

Tags: impetigo, bullous, alaa saad