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Skin-nontumor / Clinical Dermatology

Blistering disorders

Impetigo contagiosa

Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC (see Reviewers page)
Revised: 26 August 2011, last major update March 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Contagious superficial infection of skin, associated with staphylococci

Terminology
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● See also bullous impetigo

Clinical features
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● Affects face, trunk and extremities of infants and children, but may occur in elderly and in patients with immunodeficiency
● Presents with small superficial vesicles, which rapidly burst and are replaced by a characteristic, adherent thick yellow dirty crust with a margin of erythema
● Streptococcal impetigo may occasionally progress to cellulitis, or precede acute glomerulonephritis, erythema nodosum or erythema multiforme
● Outbreaks due to fusidic acid-resistant Staphylococcus aureus, associated with increased use of topical fusidic acid (Acta Derm Venereol 2010;90:52)

Clinical description
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● Small vesicles or pustules that rupture easily
● May be covered by yellow crust

Micro description
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● Vesicles just below keratin layer
● Impetigo is characterized by a split in the epidermis just beneath the stratum granulosum; the vesicle is filled with neutrophils, gram positive cocci and occasional acantholytic cells
● The dermis shows a mixed neutrophilic and lymphocytic infiltrate; neutrophils may be seen in the spongiotic stratum spinosum

End of Skin-nontumor / Clinical Dermatology > Blistering disorders > Impetigo contagiosa

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