Импетиго: симптомы, лечение и профилактика

Human disease (bacterial infection)

the bandInfobox medical condition (new)
| name = Impetigo
| synonyms = School sores, The lesions may be painful or itchy. 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. With contact it can spread around or between people. Antibiotics by mouth, such as cefalexin, may be used if large areas are affected. Antibiotic resistant forms have been found. It can occur at any age, but is most common in young children. Without treatment people typically get better within three weeks. Complications may include cellulitis or poststreptococcal glomerulonephritis.

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, 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. Skin ulcers with redness and scarring also may result from scratching or abrading the skin.

Bullous impetigo, mainly seen in children younger than two 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. Both bullous and nonbullous are primarily caused by S. aureus, with Streptococcus also commonly being involved in the nonbullous form.

Impetigo is more likely to infect children ages 2–5, especially those that attend school or day care.

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. Dried streptococci in the air are not infectious to intact skin. Scratching may spread the lesions.

Impetigo is usually diagnosed based on its appearance. It generally appears as honey colored scabs formed from dried sebum and is often found on the arms, legs, or face.

Other conditions that can result in symptoms similar to the common form include contact dermatitis, herpes simplex virus, discoid lupus, and scabies. Children with impetigo can return to school 24 hours after starting antibiotic therapy as long as their draining lesions are covered.

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 seven day antibiotic course results in resolution in children. It has been advocated that topical antiseptics are inferior to topical antibiotics, and therefore should not be used as a replacement. This recommendation is part of an effort to reduce the overuse of antimicrobials that may contribute to the development of resistant organisms 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.

There is not enough evidence to recommend alternative medicine such as tea tree oil or honey. The tropical climate and high population in lower socioeconomic regions contribute to these high rates. 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. As age increases, the rate of impetigo declines, but all ages are still susceptible. The word impetigo is the generic Latin word for 'skin eruption', and it stems from the verb impetere 'to attack' (as in impetus). Before the discovery of antibiotics, the disease was treated with an application of the antiseptic gentian violet, which was an effective treatment.