Histological differential diagnoses include spongiotic dermatitis with secondary impetiginization
, early guttate psoriasis, viral exanthem, and acute spongiotic dermatitis in the fully developed stage and postinflammatory hyperpigmentation and chronic spongiotic dermatitis in the late stage .
(3,8) Antibiotics such as topical fucidin 2 to 3 times a day or oral cloxacillin 500 mg 4 times a day are indicated only if there is secondary impetiginization
Often in severe cases there may be cracking and this usually signifies secondary impetiginization. Swab the skin and prescribe a five-day course of flucloxacillin, erythromycin or clindamycin.
As discussed in earlier sections, impetiginization is a common complication of isotretinoin therapy in particular impetiginization of cheilitis, xeroderma and eczematous lesions.
Symptoms vary from mild dryness of the vulva or penis (Figure 17) through to severe dryness, cracking, oozing and impetiginization. Frequency of micturition may be a feature in severe cases.
Based on clinical signs, we diagnosed the skin lesion as hookworm-related cutaneous larva migrans with secondary impetiginization
. The patient was subsequently treated with a single oral dose of 12 mg ivermectin.
More often, however, the staph colonization gets heavier and the skin undergoes impetiginization.
Lots of empiric evidence supports the use of intermittent antibiotics in adults with atopic dermatitis that appears to have undergone impetiginization, even when there are no overt signs of infection.
When used at higher doses --up to 800 mg of oral erythromycin three times a day after meals--may be useful for severe, widespread atopic dermatitis that has undergone impetiginization
. Higher doses can also overcome modest erythromycin resistance.
Physical examination revealed numerous skin-colored vesicles on an erythematous base, with overlying crusting and impetiginization over the distal aspects of the fingers.
However, they are often superinfected with bacteria and may exhibit signs of impetiginization. The most common location of the vesicles is on the terminal phalanx of the thumb, index, or middle finger.