Impetigo is a highly infectious bacterial skin condition induced by staphylococci or streptococci, most often Staphylococcus aureus or Streptococcus pyogenes. Skin lesions in impetigo contagiosa are most often on the face, particularly near the mouth, nose, neck, and hands. These lesions are usually multiple, widespread, and can spread. Impetigo may also develop as a complication of other skin conditions that damage the epidermis, such as chickenpox, lice infestations, scabies, or contact dermatitis.
Lesions typical of impetigo contagiosa are most often observed in the summer and autumn, in warm and humid climates. Infection with streptococci or staphylococci occurs due to skin injuries and disruption of the epidermal barrier, especially in people with reduced immunity.
Impetigo is usually observed in children, especially those attending nurseries, kindergartens, schools, or other groups.
We have two primary impetigo types: non-bullous and bullous impetigo. Additionally, there are several types of impetigo based on their locations:
Impetigo is a common bacterial infection that affects the outer layer of the skin (epidermis). It is primarily generated mainly by staphylococci (Staphylococcus aureus) and streptococci (Streptococcus pyogenes). Impetigo mainly affects children of preschool and early school age. It is an infectious disease, transmitted through direct contact or through shared objects (e.g., towels, toys), but also through shared bathing or using a swimming pool.
The factor contributing to the occurrence of the infection is a hot and humid climate, which is why it most often occurs in the summer, as well as poor personal hygiene or the carriage of staphylococci and streptococci on the skin of the armpits, groin, or nasopharyngeal mucosa.
It can occur on previously unaffected skin as primary impetigo or as a complication of other skin diseases. Skin lesions are most often located on the face, neck, and hands, and if untreated, can spread by rubbing and scratching to other parts of the body.
Impetigo, as the name suggests, is a highly contagious disease. Infection may happen through direct contact with an infected individual or indirectly – by using the same objects, such as towels, clothes, or toys. Bacteria can also be spread by scratching – hence the spread of lesions to other body parts in the same person is often observed.
Individuals who are especially in danger of getting sick are:
The initial signs of impetigo can be subtle, appearing as simple abrasions or scratches. However, as the condition progresses, it develops characteristic skin lesions that typically go through several stages.
Lesions most often occur on the face (around the nose, mouth, and chin), neck, and hands. They can also appear in other places, especially where the continuity of the skin has been damaged.
As mentioned previously, impetigo can occur in two forms. The first, described above, is the classic non-bullous form. The second form is bullous impetigo, which is characterized by the presence of larger blisters filled with serous fluid, occurring mainly in infants and young children.
Treatment of impetigo should always be under the supervision of a doctor. Although the disease often resolves on its own after 2-3 weeks, appropriate treatment significantly speeds up the healing process and prevents the spread of the infection to other people.
The foundation of therapy for impetigo is local treatment. For mild cases, using ointments or creams that contain antibiotics, such as fusidic acid, is usually sufficient. These medicines should be used 2 to 3 times daily for 7 to 10 days. It is required to rigidly adhere to the suggested duration of therapy, even if the skin lesions resolve earlier.
Usually in childrean is treated more gently and faster than in adults. This is due to a better response to local treatment and greater effectiveness of the natural defense mechanisms of the young body.
In more severe cases, when the changes are extensive or general symptoms occur, it may be necessary to use oral antibiotics. The selection of antibiotics relies on the sensitivity of the bacteria and should be preceded by an antibiogram. If MRSA infection is confirmed, the doctor may recommend special oral antibiotics.
Regardless of the treatment recommended by the doctor, it is worth following a few significant rules:
In addition to antibiotic therapy, the use of soothing and care products is also important in the treatment process. After the active infection has subsided, the skin may be dry and irritated, so it is worth using gentle moisturizing products that will accelerate the regeneration of the epidermis.
Several ailments may be mistaken for impetigo. Some examples are listed below.
Lichen planus is an immunological disease that causes chronic inflammation. It can affect the skin, oral mucosa, scalp, nails, and genital mucosa. The lesions in lichen planus appear as characteristic polygonal papules and plaques with a shiny surface, cohesive on palpation, and itching. The skin lesions are usually located on the flexural surfaces of the wrists, forearms, and lower limbs. Lichen planus is more common in individuals with liver cirrhosis, diabetes, or hepatitis.
Lichen planus presents as itchy, purple lumps. Additionally, lichen planus on mucous membranes, particularly in the mouth, is considered a precancerous condition that increases the risk of cancer.
Herpes takes the form of rashes caused by two closely related viruses: HSV-1 and HSV-2. The first of them usually causes herpes in the upper part of the body (lips and oral cavity), the second mainly on the genitals, but it also happens the other way around. Regardless of the location and type of virus, the lesions practically do not differ in appearance.
The infection is transmitted only among people through direct contact (the virus is found in secretions), and perinatal infection is possible – from a pregnant woman to the fetus or newborn.
Herpes virus infections are widespread. Serological studies indicate that the overwhelming majority of adults are infected with the HSV-1 virus, and every tenth adult has an HSV-2 infection. However, only around half of those infected experience recurrent herpes labialis outbreaks. Many diseases are asymptomatic.
The primary infection can present as acute inflammation of the gums and oral mucosa, as well as acute inflammation of the pharynx and palatine tonsils. It is often accompanied by fever. In cases of recurrent infection, the condition typically manifests as herpes labialis.
In the case of cold sores, you can glimpse a tingling or burning feeling on your lips or face for a few days before the cold sore appears. This is the most reasonable time to begin therapy.
Once the sore has formed, you will see a red blister filled with fluid forming. It will usually be hurting and tender to the touch. It is worth noting that you may have more than one blister.
Cold sores on your lips last up to two weeks and are contagious until they harden. Our first cold sore may not appear for up to 20 days after being infected with the herpes simplex virus.
During a sudden cold sore outbreak, you can experience one or more of the following manifestations:
You should see your doctor immediately if you experience eye symptoms during a cold-sore outbreak. The herpes simplex virus may lead to permanent sight loss if not treated promptly.
Cold sores on your lips go through five stages, so you should be able to notice them early and get some treatment.
The causes of shingles (herpes zoster) are mainly related to a weakened immune system. People taking immunosuppressive drugs or suffering from diseases that lower immunity are particularly at risk. The varicella-zoster virus (VZV) can remain dormant in the body for many years.
Shingles develop gradually, and its first symptoms can be confused with other ailments. According to research, the disease has a characteristic course that can be divided into several stages.
The first symptoms of shingles are:
After 3-4 days from the first symptoms, the characteristic shingles rash appears. Small pimples appear on the reddened skin, which then transforms into fluid-filled vesicles. These lesions form a characteristic band – hence the name of the disease. The rash occurs only on one side of the body and does not cross the midline, which is one of the most characteristic symptoms of shingles.
It is also worth noting that such a one-sided arrangement of skin lesions significantly facilitates the diagnosis and differentiation of shingles from other diseases associated with a rash.
Additionally, the disease is often accompanied by general symptoms such as increased temperature, weakness, headache, and poor well-being.
Contact dermatitis is a condition characterized by the development of skin lesions resulting from exposure to allergens, often chemical substances, in individuals who are sensitive to them. Although contact dermatitis is sometimes informally referred to as eczema, the two are not synonymous.
The term eczema broadly refers to an inflammatory skin disease not caused by an infection, which results in inflammation of the upper layers of the skin (the epidermis and papillary dermis). Therefore, eczema is not the name of a specific disease but describes the type of skin lesions associated with various skin conditions.
There are four types of contact dermatitis (contact eczema):
The most important factor in preventing impetigo is personal hygiene because it is through contact with objects of a sick person that infection occurs. Do not use towels, underwear, and other personal items, such as cups, cutlery, and bedding belonging to different people.
It is also worth taking care of a diet rich in vitamins and nutrients and, if possible, eliminating medications that significantly affect the effectiveness of the immune system. In addition, it is necessary to properly treat other accompanying skin infections and diseases that affect the appearance of impetigo. You should regularly check the results of tests and follow the doctor's recommendations, especially in the case of chronic diseases such as diabetes, digestive system disorders, or kidney and thyroid disorders.
In both children and adults, impetigo usually has a mild course and, with appropriate treatment, disappears without leaving permanent traces. However, in some cases, complications may occur. The most common of these are cellulitis and lymphadenitis. A rare but serious complication may be acute glomerulonephritis, especially in the case of streptococcal infections. Untreated impetigo contagiousness most often leads to complications. Appropriate therapy usually allows them to be avoided and effectively eliminates unpleasant skin symptoms.
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