What are the clinical manifestations of impetigo (impetigo, a highly contagious skin infection)?

From the Guidelines

Impetigo appears as discrete purulent lesions, nearly always caused by β-hemolytic Streptococcus spp. and/or S. aureus, characterized by red sores that quickly rupture, ooze for a few days, then form a yellowish-brown crust. These lesions commonly occur around the nose and mouth but can spread to other body areas. The infection presents in two main forms: non-bullous impetigo (more common) with honey-colored crusted sores, and bullous impetigo with fluid-filled blisters that break and leave a thin, yellow-brown crust. The affected skin is often red, itchy, and sometimes painful. The sores typically range from dime to quarter size and may appear in clusters. Impetigo is highly contagious and caused by bacteria (usually Staphylococcus aureus or Streptococcus pyogenes) that enter through breaks in the skin, as noted in the study by 1. Some key points to consider when diagnosing impetigo include:

• The condition is most common in children aged 2-5 years but can affect anyone.
• Impetigo is one of the most common skin and soft-tissue infections (SSTI) in children worldwide, as stated in the study by 1.
• If you suspect impetigo, seek medical attention as treatment typically involves topical antibiotics like mupirocin for mild cases or oral antibiotics such as cephalexin or dicloxacillin for more widespread infection, usually for 7-10 days, as recommended by 1. It is essential to note that the management of impetigo should be based on the severity of the infection and the presence of any underlying conditions, as emphasized in the study by 1. In general, the treatment of impetigo should be guided by the principles of managing skin and soft-tissue infections, including the use of antibiotics effective against Gram-positive bacteria, as recommended by 1. Overall, the diagnosis and management of impetigo require a thorough understanding of the condition's clinical presentation, causative factors, and treatment options, as discussed in the studies by 1.

From the Research

Skin Impetigo Appearance

• Impetigo is a highly contagious, superficial skin infection that most commonly affects children two to five years of age 2.
• The two types of impetigo are nonbullous impetigo (i.e., impetigo contagiosa) and bullous impetigo 2.
• The diagnosis usually is made clinically, but rarely a culture may be useful 2.

Characteristics of Impetigo

• Impetigo usually heals spontaneously within two weeks without scarring 2.
• Treatment helps relieve the discomfort, improve cosmetic appearance, and prevent the spread of an organism that may cause other illnesses (e.g., glomerulonephritis) 2.
• Topical antibiotics such as mupirocin and fusidic acid are effective and may be superior to oral antibiotics 2, 3.
• Oral antibiotics should be considered for patients with extensive disease 2.

Treatment Options

• Topical antibiotic treatment showed better cure rates than placebo 3.
• Topical mupirocin was shown to be slightly superior to oral erythromycin 3.
• There was a lack of evidence for the benefit of using disinfectant solutions 3.
• Ozenoxacin 1% cream is a prescription medicine for topical treatment of impetigo in adults and children 2 months or older 4.
• Ozenoxacin 1% cream has potent bactericidal activity and was shown to be effective and safe for the treatment of impetigo in two well-controlled Phase 3 trials 4.