Impetigo contagiosa: Description
Impetigo contagiosa (also called bork lichen, grind lichen, pus lichen, or drag) is a skin disease caused by bacteria that affects mainly children, very rarely also adults. The classic characteristic of the disease are small skin blisters filled with fluid or pus. When these blisters burst, a yellowish scab forms on the skin.
Highly contagious!
Impetigo contagiosa is highly infectious. Infection occurs directly through contact with infected persons or indirectly through use of the same objects (smear infection) such as cutlery. The disease can spread quickly, especially in schools and kindergartens – children with impetigo contagiosa should therefore stay at home. Infected persons can infect other persons as long as the open and purulent skin areas have not healed completely.
In many healthy people, the pathogens (staphylococci or streptococci) are present in the mouth and throat without symptoms of impetigo contagiosa.
Impetigo contagiosa: symptoms
The time between infection with impetigo contagiosa and the appearance of the first symptoms (incubation period) is two to ten days. The classic symptom is vesicular sputum on the skin. Doctors distinguish between small-blistered impetigo (caused by streptococci) and large-blistered impetigo (caused by staphylococci). Small blister impetigo contagiosa mainly affects the mouth and nose region and the hands, while large blister impetigo mainly affects the abdomen. Both forms are highly contagious.
The contents of the vesicles as well as the scabs are infectious. Impetigo contagiosa can easily be transmitted to healthy people via them.
In the case of large-blister impetigo contagiosa, general symptoms of illness such as fever and swelling of the lymph nodes in the affected region may also occur. However, the large-blister form is less common overall than the small-blister form.
In newborns and infants, the large-bulb form of impetigo contagiosa can be life-threatening because the barrier function of the skin is still inadequate and the immune defense is still incomplete.
Special form: non-bullous impetigo contagiosa
Impetigo contagiosa: Causes and risk factors.
Impetigo contagiosa is triggered by bacteria of the staphylococcus or streptococcus type. Accordingly, a distinction used to be made between two groups of the disease, depending on the trigger: one was large-bore impetigo contagiosa triggered by staphylococci (Staphylococcus aureus). The second group included small-bulb impetigo contagiosa caused by streptococci and non-bullous impetigo contagiosa caused by beta-hemolytic streptococci. Because this pathogen-specific classification is not clinically defensible, it is no longer used today.
The bacteria are transmitted by direct contact, especially via contaminated hands. However, they also persist for a long time on contaminated towels, dishes or other everyday objects. Thus, if such objects are shared by infected and healthy persons, transmission of the infection can also occur (smear infection).
As a rule, the physician makes the diagnosis of impetigo contagiosa on the basis of the clinical picture, i.e. the symptoms that occur. In unclear cases, a swab is taken from the skin or from the mouth and throat. In the laboratory, the pathogens can be detected in such a swab.
If the pathogen has been in the body of the affected person for a long time, specific antibodies against the pathogen can be detected in the blood and urine.
Impetigo contagiosa: Treatment
As with other diseases, treatment and prognosis for impetigo contagiosa are better the earlier the disease is detected and treated.
The following options can be considered for the therapy of impetigo contagiosa:
- In mild cases, a topical antiseptic can kill the bacteria and ensure rapid healing.
- Oral antihistamines may be given for severe itching.
In addition, moist compresses (against possible fever) and disinfecting ointments can support the therapy.
Hygiene prevents spread
To prevent infection of other persons during the therapy, a pronounced hygiene is very important:
- After each contact with sick persons, hands should be washed thoroughly with soap to kill transmitted bacteria.
- Patients should have short cut and clean fingernails. This will prevent skin injuries and rubbing in germs.
- Patients should not touch sores or crusts and should not scratch to prevent spread of bacteria.
- Wash towels, bedding and other textiles that have come into contact with the affected person at 60 degrees in the washing machine. This will kill the bacteria.
Children with impetigo must also be excused from attending kindergarten or school.
As a rule, the prognosis for impetigo contagiosa is good. If the therapy is carried out consistently, the disease heals without scars or other permanent damage.
Complications
In rare cases, complications occur such as:
- inflammation of deeper skin layers or soft tissues to which the pathogens have spread
- localized swelling of the lymphatic system and lymph nodes (regional lymphangitis and lymphadenitis)
- blood poisoning (sepsis)
- purulent conjunctivitis (conjunctivitis)
- inflammation of the middle ear (otitis media)
A rare but serious complication of impetigo contagiosa caused by streptococci is inflammation of the kidneys. For this reason, a urinalysis (urine status) is usually performed at the beginning of therapy and six weeks after completion of therapy. In most cases, the kidney inflammation occurs only after the symptoms of impetigo contagiosa have already subsided.
- if the scab spreads, continues to redden and become inflamed
- if the scab does not heal after three days of treatment
- if fever occurs
- @ if there is discomfort, shortness of breath, rash, swelling, itching, or stomach pain after taking the medication
If complications are detected early and treated promptly, affected individuals continue to have a good prognosis. Impetigo contagiosa then usually heals completely, including complications.
