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Impetigo

January 24, 2023

For the band, see Impetigo (band).
Not to be confused with Impetigore.

Impetigo is a bacterial infection that involves the superficial skin.[2] The most common presentation is yellowish crusts on the face, arms, or legs.[2] Less commonly there may be large blisters which affect the groin or armpits.[2] The lesions may be painful or itchy.[3] Fever is uncommon.[3]

Impetigo
Other namesSchool sores,[1] impetigo contagiosa
A case of impetigo on the chin
Pronunciation
SpecialtyDermatology, Infectious disease
SymptomsYellowish skin crusts, painful[2][3]
ComplicationsCellulitis, poststreptococcal glomerulonephritis[3]
Usual onsetYoung children[3]
DurationLess than 3 weeks[3]
CausesStaphylococcus aureus or Streptococcus pyogenes which spreads by direct contact[3]
Risk factorsDay care, crowding, poor nutrition, diabetes mellitus, contact sports, breaks in the skin[3][4]
PreventionHand washing, avoiding infected people, cleaning injuries[3]
TreatmentBased on symptoms[3]
MedicationAntibiotics (mupirocin, fusidic acid, cefalexin)[3][5]
Frequency140 million (2010)[6]

It is typically due to either Staphylococcus aureus or Streptococcus pyogenes.[3] Risk factors include attending day care, crowding, poor nutrition, diabetes mellitus, contact sports, and breaks in the skin such as from mosquito bites, eczema, scabies, or herpes.[3][4] With contact it can spread around or between people.[3] Diagnosis is typically based on the symptoms and appearance.[3]

Prevention is by hand washing, avoiding people who are infected, and cleaning injuries.[3] Treatment is typically with antibiotic creams such as mupirocin or fusidic acid.[3][5] Antibiotics by mouth, such as cefalexin, may be used if large areas are affected.[3] Antibiotic-resistant forms have been found.[3]

Impetigo affected about 140 million people (2% of the world population) in 2010.[6] It can occur at any age, but is most common in young children.[3] In some places the condition is also known as "school sores".[1] Without treatment people typically get better within three weeks.[3] Recurring infections can occur due to colonization of the nose by the bacteria.[7][8] Complications may include cellulitis or poststreptococcal glomerulonephritis.[3] The name is from the Latin impetere meaning "attack".[9]

Signs and symptoms

Contagious impetigo

This most common form of impetigo, also called nonbullous impetigo, most often begins as a red sore near the nose or mouth which soon breaks, leaking pus or fluid, and forms a honey-colored scab,[10] followed by a red mark which often heals without leaving a scar. Sores are not painful, but they may be itchy. Lymph nodes in the affected area may be swollen, but fever is rare. Touching or scratching the sores may easily spread the infection to other parts of the body.[11]

Skin ulcers with redness and scarring also may result from scratching or abrading the skin.[citation needed]

  •  

    Illustration of a woman with a severe facial impetigo.

  •  

    Impetigo on the back of the neck.

  •  

    A severe case of facial impetigo.

Bullous impetigo

 
Bullous impetigo after the bulla have broken

Bullous impetigo, mainly seen in children younger than 2 years, involves painless, fluid-filled blisters, mostly on the arms, legs, and trunk, surrounded by red and itchy (but not sore) skin. The blisters may be large or small. After they break, they form yellow scabs.[11]

Ecthyma

Ecthyma, the nonbullous form of impetigo, produces painful fluid- or pus-filled sores with redness of skin, usually on the arms and legs, become ulcers that penetrate deeper into the dermis. After they break open, they form hard, thick, gray-yellow scabs, which sometimes leave scars. Ecthyma may be accompanied by swollen lymph nodes in the affected area.[11]

Causes

Impetigo is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes.[12] Both bullous and nonbullous are primarily caused by S. aureus, with Streptococcus also commonly being involved in the nonbullous form.[13]

Predisposing factors

Impetigo is more likely to infect children ages 2–5, especially those that attend school or day care.[3][14][1] 70% of cases are the nonbullous form and 30% are the bullous form.[3] Other factors can increase the risk of contracting impetigo such as diabetes mellitus, dermatitis, immunodeficiency disorders, and other irritable skin disorders.[15] Impetigo occurs more frequently among people who live in warm climates.[16]

Transmission

The infection is spread by direct contact with lesions or with nasal carriers. The incubation period is 1–3 days after exposure to Streptococcus and 4–10 days for Staphylococcus.[17] Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.[citation needed]

Diagnosis

Impetigo is usually diagnosed based on its appearance. It generally appears as honey-colored scabs formed from dried serum and is often found on the arms, legs, or face.[12] If a visual diagnosis is unclear a culture may be done to test for resistant bacteria.[18]

Differential diagnosis

Other conditions that can result in symptoms similar to the common form include contact dermatitis, herpes simplex virus, discoid lupus, and scabies.[3]

Other conditions that can result in symptoms similar to the blistering form include other bullous skin diseases, burns, and necrotizing fasciitis.[3]

Prevention

To prevent the spread of impetigo the skin and any open wounds should be kept clean and covered. Care should be taken to keep fluids from an infected person away from the skin of a non-infected person. Washing hands, linens, and affected areas will lower the likelihood of contact with infected fluids. Scratching can spread the sores; keeping nails short will reduce the chances of spreading. Infected people should avoid contact with others and eliminate sharing of clothing or linens.[19] Children with impetigo can return to school 24 hours after starting antibiotic therapy as long as their draining lesions are covered.[20]

Treatment

Antibiotics, either as a cream or by mouth, are usually prescribed. Mild cases may be treated with mupirocin ointments. In 95% of cases, a single 7-day antibiotic course results in resolution in children.[20][21] It has been advocated that topical antiseptics are inferior to topical antibiotics, and therefore should not be used as a replacement.[3] However, the National Institute for Health and Care Excellence (NICE) as of February 2020 recommends a hydrogen peroxide 1% cream antiseptic rather than topical antibiotics for localised non-bullous impetigo in otherwise well individuals.[22] This recommendation is part of an effort to reduce the overuse of antimicrobials that may contribute to the development of resistant organisms[23] such as MRSA.

More severe cases require oral antibiotics, such as dicloxacillin, flucloxacillin, or erythromycin. Alternatively, amoxicillin combined with clavulanate potassium, cephalosporins (first-generation) and many others may also be used as an antibiotic treatment. Alternatives for people who are seriously allergic to penicillin or infections with methicillin-resistant Staphococcus aureus include doxycycline, clindamycin, and trimethoprim-sulphamethoxazole, although doxycycline should not be used in children under the age of eight years old due to the risk of drug-induced tooth discolouration.[20] When streptococci alone are the cause, penicillin is the drug of choice. When the condition presents with ulcers, valacyclovir, an antiviral, may be given in case a viral infection is causing the ulcer.[24]

Alternative medicine

There is not enough evidence to recommend alternative medicine such as tea tree oil or honey.[3]

Prognosis

Without treatment, individuals with impetigo typically get better within three weeks.[3] Complications may include cellulitis or poststreptococcal glomerulonephritis.[3] Rheumatic fever does not appear to be related.[3]

Epidemiology

Globally, impetigo affects more than 162 million children in low- to middle-income countries.[25] The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania.[25] The tropical climate and high population in lower socioeconomic regions contribute to these high rates.[26] Children under the age of 4 in the United Kingdom are 2.8% more likely than average to contract impetigo; this decreases to 1.6% for children up to 15 years old.[27] As age increases, the rate of impetigo declines, but all ages are still susceptible.[26]

History

Impetigo was originally described and differentiated by William Tilbury Fox around 1864.[28] The word impetigo is the generic Latin word for 'skin eruption', and it stems from the verb impetere 'to attack' (as in impetus).[29] Before the discovery of antibiotics, the disease was treated with an application of the antiseptic gentian violet, which was an effective treatment.[30][31]

References

  1. ^ a b c "Impetigo - school sores". Bettel Health Channel. from the original on 5 July 2017. Retrieved 10 May 2017.
  2. ^ a b c d Ibrahim F, Khan T, Pujalte GG (December 2015). "Bacterial Skin Infections". Primary Care. 42 (4): 485–499. doi:10.1016/j.pop.2015.08.001. PMID 26612370. S2CID 29798971.
  3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae Hartman-Adams H, Banvard C, Juckett G (August 2014). "Impetigo: diagnosis and treatment". American Family Physician. 90 (4): 229–235. PMID 25250996.
  4. ^ a b Adams BB (2002). "Dermatologic disorders of the athlete". Sports Medicine. 32 (5): 309–321. doi:10.2165/00007256-200232050-00003. PMID 11929358. S2CID 34948265.
  5. ^ a b Koning S, van der Sande R, Verhagen AP, van Suijlekom-Smit LW, Morris AD, Butler CC, et al. (January 2012). "Interventions for impetigo". The Cochrane Database of Systematic Reviews. 1 (1): CD003261. doi:10.1002/14651858.CD003261.pub3. PMC 7025440. PMID 22258953.
  6. ^ a b Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. (December 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2163–2196. doi:10.1016/S0140-6736(12)61729-2. PMC 6350784. PMID 23245607.
  7. ^ "Impetigo symptoms and treatments". www.nhsinform.scot. Retrieved 2020-05-26.
  8. ^ "Impetigo and Ecthyma - Skin Disorders". Merck Manuals Consumer Version. Retrieved 2020-05-26.
  9. ^ Concise English Dictionary. Wordsworth Editions Limited. 1993. p. 452. ISBN 9781840224979. from the original on 2016-10-03.
  10. ^ Cole C, Gazewood J (March 2007). "Diagnosis and treatment of impetigo". American Family Physician. 75 (6): 859–864. PMID 17390597. from the original on 2015-04-30.
  11. ^ a b c Mayo Clinic staff (5 October 2010). . Mayo Clinic Health Information. Mayo Clinic. Archived from the original on 28 November 2012. Retrieved 25 August 2012.
  12. ^ a b Kumar V, Abbas AK, Fausto N, Mitchell RN (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. p. 843. ISBN 978-1-4160-2973-1.
  13. ^ Stulberg DL, Penrod MA, Blatny RA (July 2002). "Common bacterial skin infections". American Family Physician. 66 (1): 119–124. PMID 12126026. from the original on 2007-09-29.
  14. ^ "Impetigo (school sores)". www.health.govt.nz. Ministry of Health. Retrieved 14 September 2017.
  15. ^ "Impetigo". Healthline. 25 June 2012. from the original on 7 October 2016. Retrieved 7 October 2016.
  16. ^ Tamparo C, Lewis M (2011). Diseases of the Human Body. Philadelphia, PA: F.A. Davis Company. p. 194. ISBN 9780803625051.
  17. ^ . state.in.us. Archived from the original on 11 December 2014. Retrieved 11 December 2014.
  18. ^ "Impetigo: MedlinePlus Medical Encyclopedia". medlineplus.gov. from the original on 2016-11-07.
  19. ^ "Self-management - Impetigo - Mayo Clinic". www.mayoclinic.org. from the original on 16 October 2016. Retrieved 7 October 2016.
  20. ^ a b c Baddour L. "Impetigo". UpToDate. Retrieved 2018-08-15.
  21. ^ Fleisher GR, Ludwig S (2010-01-01). Textbook of Pediatric Emergency Medicine. Lippincott Williams & Wilkins. p. 925. ISBN 9781605471594. from the original on 2017-09-08.
  22. ^ "Impetigo: antimicrobial prescribing - NICE guideline [NG153]". www.nice.org.uk. Retrieved 2020-05-26.
  23. ^ Mahase E (August 2019). "Doctors should treat impetigo with antiseptics not antibiotics, says NICE". BMJ. 366: l5162. doi:10.1136/bmj.l5162. PMID 31416810. S2CID 201018620.
  24. ^ "Valacyclovir Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 17 March 2019.
  25. ^ a b Bowen AC, Mahé A, Hay RJ, Andrews RM, Steer AC, Tong SY, Carapetis JR (2015). "The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma". PLOS ONE. 10 (8): e0136789. Bibcode:2015PLoSO..1036789B. doi:10.1371/journal.pone.0136789. PMC 4552802. PMID 26317533.
  26. ^ a b Romani L, Steer AC, Whitfeld MJ, Kaldor JM (August 2015). "Prevalence of scabies and impetigo worldwide: a systematic review". The Lancet. Infectious Diseases. 15 (8): 960–967. doi:10.1016/S1473-3099(15)00132-2. PMID 26088526.
  27. ^ George A, Rubin G (June 2003). "A systematic review and meta-analysis of treatments for impetigo". The British Journal of General Practice. 53 (491): 480–487. PMC 1314624. PMID 12939895.
  28. ^ "Impetigo". The British Medical Journal. 1 (4185): 448. 1941. doi:10.1136/bmj.1.4185.445-a. JSTOR 20319413. S2CID 214846855.
  29. ^ The Barnhart Concise Dictionary of Etymology. Harper Collins. 1995. ISBN 978-0-06-270084-1.
  30. ^ MacDonald RS (October 2004). "Treatment of impetigo: paint it blue". BMJ. 329 (7472): 979. doi:10.1136/bmj.329.7472.979. PMC 524121. PMID 15499130.
  31. ^ Tilbury Fox, William (1864). On impetigo contagiosa, or porrigo. England: Printed by T. Richards.

External links

January 24, 2023
impetigo, band, band, confused, with, bacterial, infection, that, involves, superficial, skin, most, common, presentation, yellowish, crusts, face, arms, legs, less, commonly, there, large, blisters, which, affect, groin, armpits, lesions, painful, itchy, feve. For the band see Impetigo band Not to be confused with Impetigore Impetigo is a bacterial infection that involves the superficial skin 2 The most common presentation is yellowish crusts on the face arms or legs 2 Less commonly there may be large blisters which affect the groin or armpits 2 The lesions may be painful or itchy 3 Fever is uncommon 3 ImpetigoOther namesSchool sores 1 impetigo contagiosaA case of impetigo on the chinPronunciation ɪ m p ɪ ˈ t aɪ ɡ oʊ SpecialtyDermatology Infectious diseaseSymptomsYellowish skin crusts painful 2 3 ComplicationsCellulitis poststreptococcal glomerulonephritis 3 Usual onsetYoung children 3 DurationLess than 3 weeks 3 CausesStaphylococcus aureus or Streptococcus pyogenes which spreads by direct contact 3 Risk factorsDay care crowding poor nutrition diabetes mellitus contact sports breaks in the skin 3 4 PreventionHand washing avoiding infected people cleaning injuries 3 TreatmentBased on symptoms 3 MedicationAntibiotics mupirocin fusidic acid cefalexin 3 5 Frequency140 million 2010 6 It is typically due to either Staphylococcus aureus or Streptococcus pyogenes 3 Risk factors include attending day care crowding poor nutrition diabetes mellitus contact sports and breaks in the skin such as from mosquito bites eczema scabies or herpes 3 4 With contact it can spread around or between people 3 Diagnosis is typically based on the symptoms and appearance 3 Prevention is by hand washing avoiding people who are infected and cleaning injuries 3 Treatment is typically with antibiotic creams such as mupirocin or fusidic acid 3 5 Antibiotics by mouth such as cefalexin may be used if large areas are affected 3 Antibiotic resistant forms have been found 3 Impetigo affected about 140 million people 2 of the world population in 2010 6 It can occur at any age but is most common in young children 3 In some places the condition is also known as school sores 1 Without treatment people typically get better within three weeks 3 Recurring infections can occur due to colonization of the nose by the bacteria 7 8 Complications may include cellulitis or poststreptococcal glomerulonephritis 3 The name is from the Latin impetere meaning attack 9 Contents 1 Signs and symptoms 1 1 Contagious impetigo 1 2 Bullous impetigo 1 3 Ecthyma 2 Causes 2 1 Predisposing factors 2 2 Transmission 3 Diagnosis 3 1 Differential diagnosis 4 Prevention 5 Treatment 5 1 Alternative medicine 6 Prognosis 7 Epidemiology 8 History 9 References 10 External linksSigns and symptoms EditContagious impetigo Edit This most common form of impetigo also called nonbullous impetigo most often begins as a red sore near the nose or mouth which soon breaks leaking pus or fluid and forms a honey colored scab 10 followed by a red mark which often heals without leaving a scar Sores are not painful but they may be itchy Lymph nodes in the affected area may be swollen but fever is rare Touching or scratching the sores may easily spread the infection to other parts of the body 11 Skin ulcers with redness and scarring also may result from scratching or abrading the skin citation needed Illustration of a woman with a severe facial impetigo Impetigo on the back of the neck A severe case of facial impetigo Bullous impetigo Edit Bullous impetigo after the bulla have broken Bullous impetigo mainly seen in children younger than 2 years involves painless fluid filled blisters mostly on the arms legs and trunk surrounded by red and itchy but not sore skin The blisters may be large or small After they break they form yellow scabs 11 Ecthyma Edit Ecthyma the nonbullous form of impetigo produces painful fluid or pus filled sores with redness of skin usually on the arms and legs become ulcers that penetrate deeper into the dermis After they break open they form hard thick gray yellow scabs which sometimes leave scars Ecthyma may be accompanied by swollen lymph nodes in the affected area 11 Causes EditImpetigo is primarily caused by Staphylococcus aureus and sometimes by Streptococcus pyogenes 12 Both bullous and nonbullous are primarily caused by S aureus with Streptococcusalso commonly being involved in the nonbullous form 13 Predisposing factors Edit Impetigo is more likely to infect children ages 2 5 especially those that attend school or day care 3 14 1 70 of cases are the nonbullous form and 30 are the bullous form 3 Other factors can increase the risk of contracting impetigo such as diabetes mellitus dermatitis immunodeficiency disorders and other irritable skin disorders 15 Impetigo occurs more frequently among people who live in warm climates 16 Transmission Edit The infection is spread by direct contact with lesions or with nasal carriers The incubation period is 1 3 days after exposure to Streptococcus and 4 10 days for Staphylococcus 17 Dried streptococci in the air are not infectious to intact skin Scratching may spread the lesions citation needed Diagnosis EditImpetigo is usually diagnosed based on its appearance It generally appears as honey colored scabs formed from dried serum and is often found on the arms legs or face 12 If a visual diagnosis is unclear a culture may be done to test for resistant bacteria 18 Differential diagnosis Edit Other conditions that can result in symptoms similar to the common form include contact dermatitis herpes simplex virus discoid lupus and scabies 3 Other conditions that can result in symptoms similar to the blistering form include other bullous skin diseases burns and necrotizing fasciitis 3 Prevention EditTo prevent the spread of impetigo the skin and any open wounds should be kept clean and covered Care should be taken to keep fluids from an infected person away from the skin of a non infected person Washing hands linens and affected areas will lower the likelihood of contact with infected fluids Scratching can spread the sores keeping nails short will reduce the chances of spreading Infected people should avoid contact with others and eliminate sharing of clothing or linens 19 Children with impetigo can return to school 24 hours after starting antibiotic therapy as long as their draining lesions are covered 20 Treatment EditAntibiotics either as a cream or by mouth are usually prescribed Mild cases may be treated with mupirocin ointments In 95 of cases a single 7 day antibiotic course results in resolution in children 20 21 It has been advocated that topical antiseptics are inferior to topical antibiotics and therefore should not be used as a replacement 3 However the National Institute for Health and Care Excellence NICE as of February 2020 recommends a hydrogen peroxide 1 cream antiseptic rather than topical antibiotics for localised non bullous impetigo in otherwise well individuals 22 This recommendation is part of an effort to reduce the overuse of antimicrobials that may contribute to the development of resistant organisms 23 such as MRSA More severe cases require oral antibiotics such as dicloxacillin flucloxacillin or erythromycin Alternatively amoxicillin combined with clavulanate potassium cephalosporins first generation and many others may also be used as an antibiotic treatment Alternatives for people who are seriously allergic to penicillin or infections with methicillin resistant Staphococcus aureus include doxycycline clindamycin and trimethoprim sulphamethoxazole although doxycycline should not be used in children under the age of eight years old due to the risk of drug induced tooth discolouration 20 When streptococci alone are the cause penicillin is the drug of choice When the condition presents with ulcers valacyclovir an antiviral may be given in case a viral infection is causing the ulcer 24 Alternative medicine Edit There is not enough evidence to recommend alternative medicine such as tea tree oil or honey 3 Prognosis EditWithout treatment individuals with impetigo typically get better within three weeks 3 Complications may include cellulitis or poststreptococcal glomerulonephritis 3 Rheumatic fever does not appear to be related 3 Epidemiology EditGlobally impetigo affects more than 162 million children in low to middle income countries 25 The rates are highest in countries with low available resources and is especially prevalent in the region of Oceania 25 The tropical climate and high population in lower socioeconomic regions contribute to these high rates 26 Children under the age of 4 in the United Kingdom are 2 8 more likely than average to contract impetigo this decreases to 1 6 for children up to 15 years old 27 As age increases the rate of impetigo declines but all ages are still susceptible 26 History EditImpetigo was originally described and differentiated by William Tilbury Fox around 1864 28 The word impetigo is the generic Latin word for skin eruption and it stems from the verb impetere to attack as in impetus 29 Before the discovery of antibiotics the disease was treated with an application of the antiseptic gentian violet which was an effective treatment 30 31 References Edit a b c Impetigo school sores Bettel Health Channel Archived from the original on 5 July 2017 Retrieved 10 May 2017 a b c d Ibrahim F Khan T Pujalte GG December 2015 Bacterial Skin Infections Primary Care 42 4 485 499 doi 10 1016 j pop 2015 08 001 PMID 26612370 S2CID 29798971 a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae Hartman Adams H Banvard C Juckett G August 2014 Impetigo diagnosis and treatment American Family Physician 90 4 229 235 PMID 25250996 a b Adams BB 2002 Dermatologic disorders of the athlete Sports Medicine 32 5 309 321 doi 10 2165 00007256 200232050 00003 PMID 11929358 S2CID 34948265 a b Koning S van der Sande R Verhagen AP van Suijlekom Smit LW Morris AD Butler CC et al January 2012 Interventions for impetigo The Cochrane Database of Systematic Reviews 1 1 CD003261 doi 10 1002 14651858 CD003261 pub3 PMC 7025440 PMID 22258953 a b Vos T Flaxman AD Naghavi M Lozano R Michaud C Ezzati M et al December 2012 Years lived with disability YLDs for 1160 sequelae of 289 diseases and injuries 1990 2010 a systematic analysis for the Global Burden of Disease Study 2010 Lancet 380 9859 2163 2196 doi 10 1016 S0140 6736 12 61729 2 PMC 6350784 PMID 23245607 Impetigo symptoms and treatments www nhsinform scot Retrieved 2020 05 26 Impetigo and Ecthyma Skin Disorders Merck Manuals Consumer Version Retrieved 2020 05 26 Concise English Dictionary Wordsworth Editions Limited 1993 p 452 ISBN 9781840224979 Archived from the original on 2016 10 03 Cole C Gazewood J March 2007 Diagnosis and treatment of impetigo American Family Physician 75 6 859 864 PMID 17390597 Archived from the original on 2015 04 30 a b c Mayo Clinic staff 5 October 2010 Impetigo Mayo Clinic Health Information Mayo Clinic Archived from the original on 28 November 2012 Retrieved 25 August 2012 a b Kumar V Abbas AK Fausto N Mitchell RN 2007 Robbins Basic Pathology 8th ed Saunders Elsevier p 843 ISBN 978 1 4160 2973 1 Stulberg DL Penrod MA Blatny RA July 2002 Common bacterial skin infections American Family Physician 66 1 119 124 PMID 12126026 Archived from the original on 2007 09 29 Impetigo school sores www health govt nz Ministry of Health Retrieved 14 September 2017 Impetigo Healthline 25 June 2012 Archived from the original on 7 October 2016 Retrieved 7 October 2016 Tamparo C Lewis M 2011 Diseases of the Human Body Philadelphia PA F A Davis Company p 194 ISBN 9780803625051 ISDH Impetigo state in us Archived from the original on 11 December 2014 Retrieved 11 December 2014 Impetigo MedlinePlus Medical Encyclopedia medlineplus gov Archived from the original on 2016 11 07 Self management Impetigo Mayo Clinic www mayoclinic org Archived from the original on 16 October 2016 Retrieved 7 October 2016 a b c Baddour L Impetigo UpToDate Retrieved 2018 08 15 Fleisher GR Ludwig S 2010 01 01 Textbook of Pediatric Emergency Medicine Lippincott Williams amp Wilkins p 925 ISBN 9781605471594 Archived from the original on 2017 09 08 Impetigo antimicrobial prescribing NICE guideline NG153 www nice org uk Retrieved 2020 05 26 Mahase E August 2019 Doctors should treat impetigo with antiseptics not antibiotics says NICE BMJ 366 l5162 doi 10 1136 bmj l5162 PMID 31416810 S2CID 201018620 Valacyclovir Hydrochloride Monograph for Professionals Drugs com American Society of Health System Pharmacists Retrieved 17 March 2019 a b Bowen AC Mahe A Hay RJ Andrews RM Steer AC Tong SY Carapetis JR 2015 The Global Epidemiology of Impetigo A Systematic Review of the Population Prevalence of Impetigo and Pyoderma PLOS ONE 10 8 e0136789 Bibcode 2015PLoSO 1036789B doi 10 1371 journal pone 0136789 PMC 4552802 PMID 26317533 a b Romani L Steer AC Whitfeld MJ Kaldor JM August 2015 Prevalence of scabies and impetigo worldwide a systematic review The Lancet Infectious Diseases 15 8 960 967 doi 10 1016 S1473 3099 15 00132 2 PMID 26088526 George A Rubin G June 2003 A systematic review and meta analysis of treatments for impetigo The British Journal of General Practice 53 491 480 487 PMC 1314624 PMID 12939895 Impetigo The British Medical Journal 1 4185 448 1941 doi 10 1136 bmj 1 4185 445 a JSTOR 20319413 S2CID 214846855 The Barnhart Concise Dictionary of Etymology Harper Collins 1995 ISBN 978 0 06 270084 1 MacDonald RS October 2004 Treatment of impetigo paint it blue BMJ 329 7472 979 doi 10 1136 bmj 329 7472 979 PMC 524121 PMID 15499130 Tilbury Fox William 1864 On impetigo contagiosa or porrigo England Printed by T Richards External links EditImpetigo at Curlie Impetigo and Ecthyma at Merck Manual of Diagnosis and Therapy Professional Edition Retrieved from https en wikipedia org w index php title Impetigo amp oldid 1128807648, wikipedia, wiki, book, books, library,

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