What is Impetigo?
Impetigo (lat. Impetigo skin disease, scab) is a contagious skin disease caused by streptococci and staphylococci.
Causes of Impetigo
An important role in the occurrence of impetigo belongs to microtraumas, maceration of the skin, as well as the ingestion of pathogenic cocci strains on it. And it can be primary and secondary (as a complication of various dermatoses, for example, eczema, scabies, pediculosis, accompanied by itching). Histological examination reveals a pustule (the main element), which develops under the stratum corneum of the epidermis; the malpigium layer (basal and prickly layers of the epidermis) is swollen and infiltrated by white blood cells.
Symptoms of Impetigo
There are impetigo staphylococcal, streptococcal and streptostaphylococcal.
Streptococcal impetigo begins with the formation of slightly elevated, prone to peripheral growth of conflict – cavity elements such as blisters with a size of 2 to 10 mm or more in diameter. Rashes are scattered or crowded in groups, surrounded by a narrow rim of hyperemia. The content of the conflict is first transparent, then it becomes cloudy and quickly dries into light yellow peels that fall off after 5-7 days, after which depigmentation remains.
Varieties of streptococcal impetigo include simple facial lichen or dry pyoderma – foci of fine-plate peeling with slight reddening of the skin.
Another variety of streptococcal impetigo is streptococcal seizures, which are more common in children. They begin with the appearance in the corner of the mouth of a bubble with a sluggish thin cover, slit-like erosion quickly forms in its place, after the removal of which a red wet easily bleeding surface with a crack in the center is detected. After 1-2 hours, the jam is again crusted. The process may be accompanied by a slight soreness when opening the mouth. The process often extends to the oral mucosa. Sometimes impetigo occurs in isolation in the mouth, where painful erosions are formed on the site of rapidly opening conflicts, covered with purulent plaque.
A variety of cystic impetigo is also a superficial panaritium, in which a conflict occurs on the nail roll in an arcuate manner around the nail in the place of burrs during injuries (for example, during a manicure), a needle prick, etc. When injured, such a conflict is opened and weeping erosion is formed in a large number of streptococci in the discharge.
Staphylococcal impetigo (folliculitis)
Folliculitis is an inflammatory lesion of the hair sac caused by staphylococci. Folliculitis can be superficial or deep. Superficial folliculitis is characterized by the formation of multiple small (1-2 mm, individual can reach 5 mm) pustules, pierced in the center by the hair and surrounded by a narrow pink border. On the 3-4th day, their contents dry out, yellow crusts appear, after falling off of which, there are no traces on the skin.
With deep folliculitis, painful red nodules of 5 mm or more in diameter are formed on the skin, sometimes with an abscess in the middle. After a few days, the nodule dissolves or suppurates, and then opens. After healing of such a nodule, a scar often remains.
Mixed (streptostaphylococcal) impetigo
With a combination of streptococcal and staphylococcal infections, a mixed (vulgar) impetigo develops, in which the content of the conflict is purulent, and the crusts are massive. When removing the crusts, a wet eroded surface is exposed.
The vulgar impetigo is usually located on the face and other exposed areas of the skin. Children, teenagers and young women are prone to the disease. Without treatment, new conflicts arise near the former rashes or in remote areas of the skin, the process often takes on a common character. It matters the transfer of infection to new areas through the hands and underwear.
Complications of impetigo
Most often, the disease ends without consequences, but there may be complications. Some of the most unpleasant complications are complications in the kidneys (jade) and in the heart (myocarditis).
Staphylococcal impetigo can be complicated by common purulent processes – abscesses and phlegmon.
Diagnosis of Impetigo
The diagnosis of impetigo is based on the clinical picture. With simple facial deprivation, a differential diagnosis is carried out with seborrheic eczema with superficial felon – with candidamycotic paronychia.
Treatment of Impetigo
Treatment of impetigo is usually done on an outpatient basis. Affected and adjacent areas of healthy skin should not be washed with water, they should be wiped 2 times a day with 2% salicylic or camphor alcohol. Some conflicts are opened and treated with an alcohol solution of aniline dyes, fucorcin, and disinfecting ointments (erythromycin, heliomycin, chloramphenicol liniment, etc.) are also used 3-4 times a day for 5-10 days until the erosion is completely epithelized. During treatment and then for 1-2 weeks. the affected area is wiped with alcohol. In the case of widespread vulgar I., in small weakened children, antibiotic therapy is carried out, with an increase in body temperature and the presence of toxicosis, usually in a children’s hospital.
In order to avoid the disease, you must follow the rules of personal hygiene, sick children should not be taken to kindergarten.
The prognosis is usually favorable, sometimes in children the process can be complicated by the development of jade.
Prevention of Impetigo
Prevention requires personal hygiene. Persons working in children’s and medical institutions with impetigo should not be allowed to work until they are cured. Children who become ill with impetigo in a maternity hospital or child care facility should be isolated and disinfection must be carried out in the maternity ward.