IMPETIGO

• Impetigo is an infectious disease caused by the bacteria Staphylococcus aureus or, less commonly, Streptococcus pyogenes
• It causes honey-coloured, crusted lesions with surrounding erythema and typically affects the face, but may also manifest on the extremities
• Impetigo is the most common bacterial skin infection among children

• Causative agent: Staphylococcus aureus in 80% of cases
• aureus strains that produce exfoliative toxins A and B are responsible for bullous impetigo
• Streptococcus pyogenes causes nonbullous impetigo only

Predisposing factors

• Warm and humid climate
• Unsanitary living conditions
• Poor personal hygiene
• Medical conditions (Atopic dermatitis , Diabetes mellitus, Immunodeficiency)

Non Bullous impetigo :

• Occurs in children of all ages, common in preschool and young school children
• Commonly over the face (especially nares) or extremities after trauma
• The initial lesion is a transient vesicle or pustule that quickly evolves into a honey coloured crusted plaque. Surrounding erythema may be present
• In severe cases there may be fever, adenitis and constitutional symptoms
• Negative Nikolsky sign

Bullous Impetigo

• Occurs commonly in the new born and older infants
• Flaccid Bullae rapidly evolve from vesicles on areas of grossly normal skin due to production of exfoliative toxin
• Positive nikolsky sign : lateral traction causes sloughing of the skin

Differential diagnosis

• Pemphigus vulgaris and bullous pemphigoid
• Bullous drug reactions
• Insect bites or burns

• Usually clinical diagnosis is done
• Microbiological culture

Internal medicines

• Ariyaradi kashaya
• Nirgundyadi kashaya
• Gopeechndanadi gutika
• Vilwadi gutika
• Guggulu panchapala choorna with madhu
• Krimighna vati

Procedures

• Triphala/ Ksheeri vriksha twak kashaya kshalana
• Karanja kashaya kshalana
• Neeli taila – ext application