Impetigo is a very common superficial cutaneous infection casued by either Staphylococcus aureus or Streptococcus pyogenes. The majority of cases are caused by Staphylococcus aureus. The condition can be quite contagious, and it is also known by the name ‘impetigo contagiosum’. The hallmark is a golden/yellow serous crust that can rapidly evolve. Regional adenopathy may also be present. Rarely the condition may be self limited and clear spontaneously. Treatment always hastens resolution. If the area is limited then treatment with topical antibiotics, such as murpirocin, twice daily for 7-14 days is effective. If the area involved is extensive, then oral antibiotics (erythromycin or first generation cephalosporins) are employed with excellent results.
Treatment pearl: If the condition is recurrent, I often will treat the inner distal 1/3 of nasal canals with murpirocin for 2 weeks to reduce the Staphylococcus aureus population that tens to reside there in high concentrations. This, often times, will eliminate recurrent cases of impetigo.
