Impetigo is an acute contagious skin rash that is generally caused by staphylococcus aureus and by the group A streptococcus bacteria. It can affect adult individuals but more commonly occurs among infants and children. This type of skin infection usually starts as red itchy sores that can soon turn into oozing blisters. Impetigo may develop around the legs, arms, trunk, buttocks and face. When it affects the face, it usually settles around the areas of the nose and the mouth. A child with impetigo can possibly be noninfectious (not contagious) after 24 hours of adequate antibiotic treatment. However, if left untreated, the child may remain contagious for several days to weeks.
Look for signs of impetigo contagiousa. This type of impetigo is caused by both the staphylococcus and streptococcus bacteria. It usually starts as a small red-colored papule that is mostly situated around the area of the nose or the mouth. The papule will increase in size peripherally but remains flattened. It usually bursts quickly and oozes a yellowish fluid or pure pus--that will soon dry up to become a honey-colored crust covering the affected area. Since the papule can be itchy, the patient will be tempted to scratch it. This can possibly form new papules around nearby areas since this impetigo is highly contagious. After days of medication, the crust wears off, leaving a red spot that gradually fades. There will be no fever with this type of impetigo, but tender and swollen lymph nodes may be present near the infected area.
Watch for some larger fluid-filled blisters. Bullous impetigo is a type of impetigo that is mainly caused by staphylococcus bacteria. When this organism infects the skin, it forms fluid-filled blisters that occupy the deeper part of the epidermis (the outer layer of the skin). It typically settles around the areas of the arms, legs, trunk and buttocks. These blisters are usually itchy and reddish but not painful and sore. When they burst, their clear and cloudy fluid dries up to form faded yellow scabs. This type of impetigo lasts longer than the other types and usually affects infants and younger children (less than 2 years of age).
Consult your doctor if the blisters appear deeply invasive. Ecthyma is considered as the most severe type of impetigo. It usually develops when infection from the blisters formed on the epidermis (outer layer) penetrates into the dermis (deeper part of the skin). These deep-penetrating pus-filled ulcers are usually painful and are covered by thicker and harder scabs, as compared to the other two types of impetigo. The areas affected by ecthyma are the feet, ankles, legs, thighs and buttocks. Lymph nodes located near the affected areas may become swollen, and since the infection affects the deeper layer of the skin, scars may remain when the ulcers heal.