Daily Bolus of LR: Bullous Impetigo

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September 16, 2011 by dailybolusoflr

Bullous Impetigo


·         Bullous impetigo is most commonly seen in neonates, but can be seen in older children

·         Multiple pictures seen here   http://dermatlas.med.jhmi.edu/derm/result.cfm?OutputSet=2&BO=AND&Diagnosis=16


·         It is caused by a toxin producing staph aureus and is considered a localized form of staph scalded skin syndrome

·         Superficial vesicles form first and then progress into bullous lesions which rupture and form yellow crusts

·         There is NO or minimal surrounding erythema

·         It most commonly occurs in intertriginous areas

·         It is less contagious than non-bullous impetigo, which is the highly contagious form

·         A pathognomonic finding is a “collar­ette” of scale surrounding the blister roof at the periphery of ruptured lesions    http://dermatlas.med.jhmi.edu/derm/IndexDisplay.cfm?ImageID=1148293457



·         Treatment is the same as for non-bullous impetigo

o   For most uncomplicated infections is topical mupirocin (Bactroban)

o   It should not be used around the eye

o   For extensive infection, consider systemic treatment with topical anti-staphylococcal antibiotics or clindamycin or bactrim (to cover MRSA)

o   Good hygeine, washing sheets and towels



Ref: Am Fam Physician. 2007 Mar 15;75(6):859-64.


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