Impetigo

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍skin rash

Location is on ‍faceneckarmhandlegfootthoraxabdomenflankback

Onset was ‍gradualsudden, ‍spontaneoustriggered by ‍, ‍whileafter ‍

Symptoms include:

‍red sores

‍itching

‍crusts

‍blisters

‍honey-colored crusts

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍swollen lymph nodes



Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍similar symptoms in close contacts with impetigo

‍recent skin injury

‍poor hygiene

no history of: ‍impetigo, ‍eczema, ‍diabetes, ‍immunodeficiency

no use of: ‍topical antibiotics





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Skin: ‍rashlesions on ‍





ASSESSMENT:

‍Impetigo ‍likelysuspectedpossible

DDx: impetigo, cellulitis, HSV infection, herpes zoster, contact dermatitis, atopic dermatitis, scabies, folliculitis, insect bite reaction, drug eruption, bullous pemphigoid, pemphigus vulgaris, staphylococcal scalded skin syndrome, fungal infection, eczema herpeticum, allergic reaction, dermatitis herpetiformis, bullous lupus erythematosus





PLAN:

Investigations:

- Skin swab for culture

Treatments:

- ‍Topical antibiotics

- ‍Oral antibiotics if large area or no response to topical antibiotics

- Good hygiene practices

- Avoidance of scratching

- Covering of lesions

- School leave until improved

Further care:

- Follow-up in ‍ ‍daysweeks

- Return if redness expands or fever develops