Rashes - impetigo

Impetigo is a superficial infection of the epidermis caused by Staphylococcus aureus, group A beta-haemolytic streptococci or maybe even MRSA. Children should stay away from school until lesions are crusted and healed, or 48 hours after commencing antibiotic treatment. Several clinical forms of impetigo exist. 1. Non-bullous impetigo is the usual form. Red macules form initially, then golden crusts. It is itchy but not painful. Regional lymphadenopathy is common. 2. Bullous impetigo. Here there is sloughing of the epidermis due to toxin production. Vesicles/bullae may be on face, buttocks, nappy area or trunk. Inpatient care is required for infants with bullous impetigo and patients with widespread impetigenised dermatitis who may develop sepsis or dehydration.

What are the 3 types of impetigo? #RoshQuiz #FOAMed #FMRevolution #NursePractitioner #PANCE #PEM #PedsEM pic.twitter.com/94jnKr07ga

— Rosh Review's Adam Rosh (@RoshReview) June 15, 2017

Treatment: 1. use mupirocin nasal ointment to eradicate nasal carriage when treating impetigo on the face 2. Remove the scab, and then apply local treatment - fucidin and bactroban 3. Systemic if that fails 4. Remember not to go to school 5. Excellent hygiene

Impetigo. Local treatment first. Fucidin and bactroban. Not to school or nursery for 48 hours. #foamed

— South London EM FOAM (@slemfoam) October 16, 2014

References https://wikem.org/wiki/Impetigo https://www.rcemlearning.co.uk/references/cellulitis/ http://www.publichealth.hscni.net/sites/default/files/Guidance_on_infection_control_in%20schools_poster.pdf https://www.summitmedicalgroup.com/library/pediatric_health/hhg_impetigo/ http://www.bad.org.uk/for-the-public/patient-information-leaflets/impetigo/?showmore=1&returnlink=http%3A%2F%2Fwww.bad.org.uk%2Ffor-the-public%2Fpatient-information-leaflets#.W4g8xehKjIU