Diagnosis: Impetigo
Skin lesions that proved to be impetigo. Impetigo is usually caused by Group A Streptococcus sp. or Staphylococcus aureus bacteria. Note how the maculopapular lesions resemble syphilis, which is cause. Clinical photograph sourced from Wikimedia Commons (Public domain). Attribution: US Gov.
Non-bullous: begins as erythematous macule → vesicle/pustule → characteristic golden/honey-colored crusts. Bullous: flaccid bullae that rupture leaving shallow erosions with collarette of scale. Perioral and perinasal distribution common.
More common in warm, humid climates. Risk factors: crowding, poor hygiene, minor skin trauma, pre-existing dermatoses (eczema, scabies). Highly contagious — outbreaks in schools and daycare. MRSA increasingly common cause.
Limited: topical mupirocin or retapamulin. Extensive/bullous: oral antibiotics (cephalexin, dicloxacillin; TMP-SMX or doxycycline if MRSA suspected). Wound care: gentle debridement of crusts. Keep lesions covered to prevent spread.
Herpes simplex, Contact dermatitis, Tinea corporis, Bullous pemphigoid (bullous form), Eczema herpeticum, Varicella
Post-streptococcal glomerulonephritis is a potential complication (monitor urinalysis if GAS confirmed). Bullous impetigo is caused by S. aureus exfoliative toxins. Distinguish from eczema herpeticum which requires antiviral therapy.
Tags: impetigo, bacterial, infection, staphylococcal, pediatric