Impetigo Causes, Symptoms & Treatments

By jolene
Reviewed: Dr. Mera
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Impetigo is a skin condition that is very common and contagious, as it involves the superficial layer of the skin. While this condition is usually more likely to affect children, it can also occur in adults at any age. In some regions, impetigo is also known as “school sores”. In the year 2010, impetigo affected approximately 2% of the global population (roughly 140 million individuals). Some of the risk factors for impetigo include attendance to daycare, malnutrition, poor hygiene, crowded living situation, contact sports, diabetes, and open wounds in the skin (i.e. insect bites, scabies, herpes, or eczema). Transmission can occur if there is direct contact with lesions of an affected individual, or through fomites (i.e. toys, clothing).

To prevent it from spreading, frequent hand washing and cleaning the affected area can be useful. The condition can be self-limited within a few weeks; however, some cases may require the use of topical and/or systemic antibiotics. Furthermore, some rare complications, such as cellulitis and acute post-streptococcal glomerulonephritis (APSGN), can occur.

Cause #1: Staphylococcus Aureus

Staphylococcus aureus is a bacterium that can be found in the human body. It is commonly found in the nose, skin, and respiratory tract. While it is not always pathogenic (it is not always harmful), it can cause many different conditions such as skin infections (i.e. folliculitis, impetigo), food poisoning, respiratory tract infections, bone and joint infections (i.e. osteomyelitis, septic arthritis), and more. Skin infections such as impetigo most frequently occur when there is a wound or disruption of the skin due to trauma, skin infection (i.e. varicella, herpes), or insect bites. The bacteria invade the wound and start colonizing the area causing an infection.

There are two variants of impetigo, known as bullous and non-bullous impetigo. S. aureus can be responsible for either variant; however, when it produces exfoliative toxins (exfoliatins A and B) it will give rise to bullous impetigo. This variant usually occurs on intact skin and can involve mucous membranes (unlike non-bullous impetigo). It consists of small or large superficial lesions called bullae (blisters containing serous fluid) that quickly rupture and spread locally (face, trunk, and upper extremities) through autoinoculation. Finally, there are resistant strains of the bacteria, such as methicillin-resistant S aureus (MRSA), that can present with different cutaneous manifestations (i.e. abscesses).


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