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im·pe·ti·go(im'pe-tī'gō), Avoid the misspelling/mispronunciation infantigo.
Synonym(s): impetigo contagiosa, impetigo vulgaris.
impetigo, impetigo contagiosa (im?pe-te'go, -ti'go ) [L. impetigo, scabby eruption on the skin]
The infection is highly contagious and spreads easily among infants, children, and the elderly, with outbreaks related to such predisposing factors as poor hygiene, crowded and unclean living conditions, warm climate, malnutrition, and anemia. Topically applied mupirocin ointment, related drugs, or oral agents effective against staphylococcus and streptococcus are used to treat the infection. Mupirocin also eliminates nasal carriage of the offending organisms.
The appearance, location, and distribution of lesions are documented, along with any associated symptoms (pruritus, pain). Family members are taught to keep the skin clean and dry, removing exudate 2 to 3 times daily by washing the lesions with soap and water; warm saline soaks or compresses may be applied to remove stubborn crusts. Patients and families are taught the importance of not sharing washcloths, towels, or bed linens; the need for thorough handwashing and frequent bathing with a bactericidal soap; and the urgency for early treatment of any purulent eruption to limit spread to others.
Prescribed treatment must be continued for 7 to 10 days even if lesions have healed. Nonprescription antihistamines may be used to reduce itching. The fingernails should be cut and, if necessary, mittens applied to prevent further in-jury if the patient is unable to avoid scratching. Diversional activities appropriate to the patient's developmental stage are encouraged to distract from local discomforts. Black patients may develop deeper inflammation than whites and should be informed that this may result in hypopigmentation or hyperpigmentation changes after the inflammation has subsided. The school nurse or employer is notified of the infection, and family members are checked for evidence of impetigo. The patient can return to school or work when all lesions have healed.