What is it ?
Impetigo is the most common bacterial skin infection in children . This infection is caused by staphylococcus aureus or streptococcus, which are frequent in the nostrils, and are transmitted by manuportage. Impetigo is very contagious and is characterized most often by the rapid appearance of vesicles (small blisters of water or pus) then crusts or “bubbles” (large blisters of water or pus) on the skin of the face and the body.
Symptoms of Impetigo
Impetigo is described in two forms:
- Crusty impetigo . This is the most common form since it concerns 70% of cases. It is characterized by the appearance of vesicles with an inflammatory periphery (red, sensitive and sometimes a little swollen). The vesicles break in a few days and their oozing causes the appearance of yellow crusts like honey.
- Bullous impetigo . It is characterized by the appearance of bubbles 1 to 2 cm in diameter, whose content is purulent. The bubbles break in a few days and leave areas without skin, called erosions, the size of the pre-existing bubble, but tending to widen and spread on the sides.
People at risk for Impetigo
The impetigo is a condition that occurs mainly in children under 10 years , particularly from the community development (nursery, school, etc.).
Newborns and infants are also affected by impetigo because they are more fragile.
If impetigo in adults , the alcoholism and drug addiction, diabetes and immune deficiency (treatment with cortisone or other immunosuppressive drugs, AIDS / HIV, etc.) can cause complications of type ecthyma, especially in the lower limbs, where the impetigo is covered with a blackish crust and tends to spread. The ecthyma tends to be complicated by infections of the tissues located under the skin: it acts of infectious cellulitis (infection of the subcutaneous layers). The infection may also tend to spread along the lymphatic channels: it is lymphangitis (red inflammatory trail that goes up the leg up).
The Prevention of impetigo involves:
- Good daily hygiene of the skin;
- Eviction of the nursery or school for affected children to avoid contagion.
Medical treatments of Impetigo
The treatment of impetigo requires consultation with a doctor because complications can arise in case of inappropriate treatment such as extension of lesions, abscess, sepsis, etc.
In any case, you should check your tetanus status and tell your doctor. In case of impetigo, revaccination is necessary if the last injection is more than ten years old.
The rules of hygiene are important:
- Pierce the bubbles with a sterilized needle, passing it through a flame for example;
- Favor the fall of the crusts by soaping the lesions daily;
- Try to prevent children from scratching lesions;
- Wash your hands several times a day and cut the nails of affected children.
The treatment prescribed by the doctor is based on antibiotics:
- Local antibiotics
They are applied to the lesions 2 to 3 times a day until complete healing which usually takes a week. Local antibiotics are most often based on fusidic acid (Fucidine) or mupirocin (Mupiderm).
- Oral antibiotics:
The antibiotics to be used are left to the discretion of the doctor but are most often based on penicillin (cloxacillin such as Orbénine), amoxicillin and clavulanic acid (Augmentin) or macrolides (Josacine).
Oral antibiotics are indicated in particular in case:
- extensive, diffuse or out-of-treatment impetigo;
- Presence of local or general signs of severity (fever, lymph nodes, lymphangitis trail ( it is a red cord rising up along a limb most often, related to the spread of the infection of the skin in the lymphatic channels), etc.);
- high risk factors in neonates and infants, or in weak adults with alcohol, diabetes, immunodeficiency, or failure to respond to local treatment);
- sites difficult to treat by local care or at risk of complications, under the layers, around the lips or on the scalp;
- In case of allergy to local antibiotics.