Bork Lichen (Impetigo Contagiosa)

Impetigo contagiosa – colloquially called bork lichen – (synonyms: Pus rash; pustule; grind rash; grind blisters; grind lichen; grind nodules; smut; Fox’s impetigo; impetiginization; impetiginous eczema; impetigo; impetigo bullosa; impetigo circinata; Impetigo contagiosa due to staphylococci; Impetigo contagiosa due to streptococci; Impetigo neonatorum; Impetigo vulgaris; Impetigo vulgaris Unna; mpetigo simplex; non-bullous impetigo; Streptococcal impetigo; ICD-10-GM L01. 0: Impetigo contaginosa) is a highly infectious bacterial infection of the skin not associated with the skin appendages (hair follicles, sweat glands).

Impetigo contagiosa is an infection with pus-forming bacteria (pyoderma).

In about 80% of cases, Staphylococcus aureus is the sole causative agent. In 10% of cases, there is a sole infection with Streptococcus pyogenes.

The pathogen reservoir is humans. Germ reservoir is often the nasopharynx.

Occurrence: Both Staphylococcus aureus and Streptococcus pyogenes occur ubiquitously, i.e., everywhere.

Seasonal accumulation of the disease: Impetigo contagiosa occurs mainly in the warm season.

Transmission of the pathogen (route of infection) is fecal-oral (infections in which pathogens excreted with feces (fecal) are absorbed via the mouth (oral); smear infection), e.g., from the skin of the diseased person to the skin of other persons or hand contact with contaminated surfaces.Indirect infections via food have been described, but are very rare.

The incubation period (time from infection to onset of disease) is 2-10 days.

The following forms of impetigo contagiosa are described:

  • Large blistered impetigo contagiosa (impetigo bullosa; bullous impetigo) – triggered more often by Staphylococcus aureus.
  • Small-bubble impetigo contagiosa (non-bullous impetigo) – triggered by beta-hemolytic group A streptococci (Streptococcus pyogenes) (more common form).

Frequency peak: the disease occurs mainly in children and newborns.

The duration of infectivity exists especially during the duration of clinically manifest symptoms.

Course and prognosis: As a rule, skin infections with staphylococci and streptococci can be treated well with 2% quinolinol ointment (if necessary also: polyvidone iodine ointment) or a disinfecting soft zinc paste; local antibiotics, e.g. fusidic acid, getamicin are also used. The affected skin areas should be covered with gauze. As far as hands are affected, they should be covered by a tubular bandage so that the transmission of bacteria by scratching the fingers (= autoinoculation) is avoided.