Impetigo history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Impetigo has a contagious course. People who suffer from cold sores have shown higher chances of suffering from impetigo. Patients with impetigo usualy have a history of recurrent lesions, immunodeficiency and trauma or abrasions. Symptoms may vary from vesicles to bullae that can be seen localized in early disease or spread to trunk and extremities if not taken care of. Fever and fatigue are important symtoms associated with seeking medical attention.^[1][2]

Patients may present with one or more pimple-like lesions surrounded by reddened skin. Lesions fill with pus, then break down over 4–6 days and form a thick crust. Impetigo is often associated with insect bites, cuts, and other forms of trauma to the skin. Itching is common.^[1]

The history of a patient with suspected impetigo may inclucde:^[1]

• Fever
• Trauma
• Immunodeficiency
• Itching
• Recurrent vesicles or bullae in the past
• Contagious spread of lesions
• Non-bullous impetigo has a history of self resolution in 1-2 weeks
• Fatigue
• Axillary pain or pain and swelling in other locations

The symptoms of impetigo include some generalized as well as specific symptoms for the various types of impetigo.^[1]

Generalized symptoms of impetigo include:

• Fever
• Itching
• Fatigue
• Weakness
• Painful lesions
• Diarrhea in children

• Very contagious course
• Multiple lesions around the lips
• Lesions around the nose
• Lesions on the face, extremities and any skin location
• Lesions are primarily pustules and vesicles
• Honey-colored crusting of lesions occurs when the vesicles rupture
• Pain in the axillae

• Less contagious course
• Face, axillae, extremities, trunk or anal region may be affected
• Initial lesions are bullae with clear fluid
• The fluid in the bulae can turn yellow and less transparent with time
• Very fragile lesions
• Crusting is less frequenting after rupture
• Scaling may be present in the form of a ring

• Ulcer
• Punched-out or raised borders
• Golden brown crust

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