- Impetigo is a contagious bacterial skin infection, mainly caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes. It often affects children, although it can affect people of all ages.
- Impetigo: The diagnosis is clinical. There is no need to carry out additional examinations.
- With only hygiene measures, impetigo usually heals in 2 to 3 weeks.
- In the event of impetigo, adopting hygiene measures and covering the lesions are the first steps to take to limit scratching and the spread of the lesions to the patient and to prevent contamination of those around them.
- In view of the possible difficulties in applying these measures in young children who have impetigo and who are in contact with other children, antibiotic treatment should be adopted in addition to hygiene measures. Local antibiotic treatment is preferred over a small clinical presentation (< 2% of the total body surface area + ≤ 5 active lesions without rapid extension). Mupirocin 2% cream or possibly fusidic acid 2% cream should be applied to the lesions 2 to 3 times a day for 5 to 10 days in order to limit transmission to those around them. Impetigo lesions appear to be no longer contagious 24 to 48 hours after the start of appropriate antibiotic treatment.
- In older children and adults with mild impetigo, given the often favourable course of the infection, applying hygiene measures and deferring the decision on antibiotic treatment by the skin for one week seems reasonable to reduce exposure to an antibiotic and limit the emergence of bacterial resistance.
- The hygiene measures are as follows:
- Wash the lesions several times a day with soap and water;
- Wash hands with soap and water after touching impetigo lesions;
- Do not use the towel used to dry the affected area on healthy areas, and wash it after each use;
- Avoid scratching lesions, keep nails short and clean;
- Cover the lesions with dry dressings;
- Avoid sharing towels and clothes in contact with the lesions;
- Wash laundry in contact with the lesions daily until the lesions are dry.
- The application of an antiseptic to impetigo lesions has not been shown to be more effective than washing with soap and water.
- When it is not possible to cover impetigo lesions due to their extent or location, it is prudent to remove infected children from school or nursery up to 72 hours after starting antibiotic treatment. There is no need for expulsion from school if the lesions are protected.
- The search for glomerulonephritis by urine control 3 weeks later in search of proteinuria is very questionable here. It is a very rare complication in France and is mainly associated with profuse forms of impetigo.
