Impetigo

The Impetigo ( from Latin impetere " attack ", contagiosus " contagious " ) is a highly contagious bacterial skin disease with a peak incidence in children and newborns. Synonymous with the terms impetigo vulgaris, also called " Grind bubbles ", " impetigo ", " impetigo ", " impetigo ", " Borkenflechte ", " Schmierflechte ", " train ", " tow shit " or " tow cable" can be used.

Cause

Cause of the infection are bacteria that spread with specific pathogenicity in the skin and can destroy tissue. Both the large -bubble form ( bullous impetigo ) and in the small -bubble shape is predominantly Staphylococcus aureus encountered. In both forms, but especially the small -bubble shape can often also Streptococcus pyogenes ( group A streptococcus ) be the cause of the skin disease. In addition, mixed infections are possible.

Most often children are affected because the disease can spread epidemic by smear infection in community facilities (schools, kindergartens ) or among siblings. An impetigo is observed in all other age groups, particularly in patients with atopic eczema because the pathogens can very easily penetrate into deep skin layers by microtrauma on scratching the skin.

Disease picture

A distinction is made between a small bubble and a large vesicular variant of impetigo. Both forms begin predominantly on the face first with red spots ( macules ), which pass rapidly filled with water- clear liquid bubbles. The bubbles are each surrounded by a narrow areola.

Small-Vesicle Impetigo

In the small -bubble Impetigo bubbles are often not seen. The walls of the bubbles are very thin, so they quickly burst. The base of the bladder is heavily exuding through exudation. Dries the liquid, characteristic honey-colored crusts on an erythematous base.

Bullous Impetigo

In the coarse -bubble Impetigo many bubbles are present. They are also initially filled with water- clear liquid, but in the course deteriorate initially whitish- gray and creamy - purulent. When rupture or scratching the sores causes red, eroded surfaces that shine moist. In contrast to the small vesicular impetigo hardly stronger crusts form.

Therapy

Treatment of Impetigo is loud IfSG § 24 with respect to IfSG § 34 "to the extent permitted only physicians as part of the professional practice of medicine ," which means that medical practitioner or other health professional, this treatment may not perform. In addition, special rules for sufferers exist in public institutions, according to IfSG § 34 to prevent dissemination.

According to current treatment guidelines of the German Dermatological Society systemic antibiotic therapy is usually not provided. Hygiene measures have an important role in the treatment: The avoidance of scratching the affected skin, regular hand washing and regular hot washing of the body present at the clothing and towels to insulate the infection and prevent further infections. The fingernails of those affected should be cut short so that the possibility of scratching and thus a retransmission is reduced. The connecting and covering and avoid scratching promotes the spontaneous healing tendency of the disease.

Local therapy can be supported with antibiotic-containing ointments ( fusidic acid, mupirocin, retapamulin ). Disinfecting solutions, baths and envelopes can be used in addition. Only advanced cases make systemic treatment with antibiotics ( eg cephalosporins ) are required.

Course

The incubation period is between two and ten days, possibly longer. The disease is infectious as long until the open, festering skin have healed.

When consistently applied therapy, impetigo usually heals without consequences. The skin scales and crusts detach from the skin healthy so that they either fall off or can be removed by hand. Rare attack the pathogen on to deeper skin layers and cause the nail bed, Nagelfalzentzündungen or abscesses. Community facilities such as kindergartens or schools may be visited by the patient after healing of infected skin again.

In approximately 5 % of patients occurs after infection (only for the small -bubble form) an inflammatory response in the kidney (post- streptococcal glomerulonephritis ). This usually heals without consequences.