Impetigo is a topic covered in the 5-Minute Emergency Consult.

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  • Impetigo is a common infection of the skin
  • Primary infection:
    • Infection of minor breaks in the skin
  • Secondary infection:
    • Infection of previously existing skin lesions, known as “impetiginization”
  • Most prevalent in children aged 2–5 yr
  • More common in summer months and warm and humid climates
  • Predisposing factors:
    • Minor trauma, esp. around nose area
    • Burns
    • Insect bites
    • HIV infection
    • Diabetes mellitus
    • Existing skin disease
    • Varicella infection
  • Complications:
    • Acute poststreptococcal glomerulonephritis
      • 1–5% in patients with nonbullous impetigo
    • Sepsis
    • Cellulitis
    • Endocarditis
    • Toxic shock syndrome
    • Staphylococcal scalded skin syndrome (SSSS)


  • Classic impetigo:
    • The result of bacteria entering through traumatic skin portal from scratch, abrasion, or insect bite
    • Caused by Staphylococcus aureus, group A β-hemolytic streptococci, or both
    • Often associated with poor hygiene
    • Treatment of both streptococci and S. aureus
  • Bullous impetigo:
    • Caused by S. aureus, phage group II
    • Epidermal cleavage is caused by staphylococcal exfoliative toxins A, B, and D, which are serine proteases that bind and cleave desmoglein 1, an intercellular adhesion molecule in desmosomes

Pregnancy Considerations
Zinc supplementation to mother during pregnancy may lead to decreased incidence in infants

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