Impetigo: The Honey-crusted Sore

I saw 4 cases of impetigo this past week (a typical week), but this was by far the most impressive case I had seen in a while. (Thanks to my patient’s mom who was willing to let me snap a pic for educational purposes.) Most people have heard the word, “impetigo,” and know it’s not a good thing, but don’t know much about it.

Impetigo is a common, bacterial skin infection. The infection typically happens on the face around the nose and mouth, but can occur in other places. It is really contagious, common in preschool-aged kids, and characterized by honey-colored scabbing. The infection is usually caused by Staphylococcus aureus and /or Streptococcus pyogenes (i.e., Staph or Strep). What happens is that the infection creates little sores that will break open/leak pus or fluid. The fluid dries creating the tell-tale honey crusted colored scab.

The classic story involves a kid in daycare or preschool who has a cold with a runny nose. The skin around the nose gets red and compromised from the continuous drainage. Whether the kiddo gets it from another kid (sharing infected toys, etc.) or from himself isn’t always clear, but it happens.

The treatment involves a prescription antibiotic ointment (e.g., Mupirocin ointment). Sometimes, the infection is so bad that you’ll need oral antibiotics. Diagnosis is usually made by inspection, but if your doc is concerned about the possibility of MRSA (an antibiotic resistant strain of Staph), she may culture the wound as well. Generally, impetigo is easily treated and doesn’t leave scarring. You can prevent the spread with careful hand washing and washing things that the infected child has been in contact with.  If you’re concerned your child may have impetigo, better make an appointment with your doc.