Alright, so impetigo is a bacterial infection.
Again, i know we're putting it into the fungal skin
infections, but we're gonna talk about this one for a moment.
It's most commonly caused by staph and strep.
Usually, it starts off with little papules that
then progress to vesicles with surrounding erythema
and then ultimately those vesicles can start
to fill with pus and then we've got pustules.
When the pustules rupture,
out comes this thick, sticky, golden crust.
And again, that's the pathognomonic
terminology you might see in a board question.
Most commonly though, we're seeing
this in kids like ages 2-5 years old
or in much older patients,
elderly patients or those with HIV.
Now if you see any bullous lesions,
think more about staph rather than strep,
occasionally you can even see an
ulcerated area called an ecthyma.
These lesions are not typically itchy.
They can however progress fairly
rapidly to deeper skin infections
with some very serious complications that
are best left for a different lecture.
If it's mild, you can just get away with topical mupirocin.
Whereas if it's moderate or severe, you're gonna need
an oral agent that's targeting common strep or staph
like cephalexin or dicloxacillin,
if you're not worried about MRSA or anything like that.
So again, this lesion that our patient has, is erythematous but
it lacks all the vesicles and pustules and sticky golden crusts.
So I think impetigo is out as well.