Impetigo contagiosa

Impetigo contagiosa: description

Impetigo contagiosa (also Borkenflechte, Grind lichen, Eiterflechte or Schleppe called) is a bacterially caused skin disease that affects mainly children, very rarely adults. The classic hallmark of impetigo contagiosa are small blisters that are filled with fluid or pus. When these bubbles burst, a yellowish scab forms on the skin.

Impetigo contagiosa is highly infectious. The infection takes place directly through contact with infected persons or indirectly through the use of the same objects (smear infection). Especially in schools and kindergartens, the disease can spread quickly: children with impetigo contagiosa should therefore stay at home.

Most of the pathogens invade scratched or injured skin. Children with atopic dermatitis, chicken pox, scabies or a weakened immune system are therefore particularly at risk of infection – the pathogen can easily penetrate into the body with them.

In many healthy people, the pathogens (staphylococci or streptococci) are located in the mouth and throat, without symptoms of impetigo contagiosa occur.

The time between infection with impetigo contagiosa and the onset of the first symptoms (incubation period) is two to ten days. Infected people can infect other people as long as the open and purulent skin has not completely healed.

Impetigo contagiosa: symptoms

The classic symptom of bark lichen is the vesicles of the skin. Doctors differentiate between the small-bubble Borkenflechte (caused by streptococci) and the big bubble bark lichen (caused by staphylococci). The small-bubble impetigo contagiosa affects mainly the mouth and nose region as well as the hands, the large-bladder especially the abdomen. Both forms are highly contagious.

Usually the impetigo contagiosa starts with a local, itchy skin redness (Erythema) in the mouth and nose area. As a result, small blisters and pustules form on the skin. These are filled with liquid or pus and burst easily. The typical honey yellow scab on the skin forms due to this bursting (purulent lichen). It typically occurs in the form of asymmetric, sharply defined and red-lined crusts. These shed in the course and eventually fall off by itself.

The contents of the blisters as well as the scab are infectious. Impetigo contagiosa can easily be transmitted to healthy people.

In the case of large-bladder impetigo contagiosa, general symptoms of illness such as fever and lymph node swelling may also be added in the affected region. The large-bubble shape is less common than the small bubbles.

Special form: non-bullous impetigo contagiosa

In non-bullous impetigo contagiosa, blistering on the skin is eliminated. Often the bark lichen is then only recognizable by the reddened skin and the formation of the yellowish scab occurring around the nose. Non-bullous impetigo contagiosa requires a long duration of treatment. It can affect all parts of the body.

Impetigo contagiosa: causes and risk factors

Impetigo contagiosa is triggered by two different bacterial genera. Accordingly, one distinguishes:

• Large bubble impetigo contagiosa: triggered by staphylococci (Staphylococcus aureus)
• Small bubble impetigo contagiosa: triggered by streptococci
• Non-bullous impetigo contagiosa: triggered by beta-hemolytic streptococci

The bacteria are transmitted by direct contact, especially on contaminated hands. But they also keep a long time on contaminated towels, dishes or other everyday objects. If such items of infected and healthy people used together, it can also lead to a transfer of infection (smear infection).

Impetigo contagiosa: examinations and diagnosis

In general, the doctor diagnoses impetigo contagiosa based on the clinical picture, that is, the symptoms that occur. In unclear cases, a smear is taken from the skin or from the mouth and throat area. In a laboratory, the pathogens can be detected in such a smear.

If the pathogen has been in the victim’s body for some time, specific antibodies against the pathogen in the blood and urine can be detected.

Impetigo contagiosa: treatment

As with other diseases, Impetigo contagiosa also applies: Therapy and prognosis are better the sooner the disease is detected and treatment is started.

There are two different options for treating impetigo contagiosa:

• In mild cases, a locally applicable antiseptic kill the bacteria and ensure a fast healing process.
• In severe cases, a local antiseptic treatment is not enough. Instead, one becomes antibiotic (mostly amoxicillin) prescribed, which is taken orally.

Moist envelopes (against possible fever) and disinfectant ointments can accompany a therapy and locally reduce the symptoms.

In order to avoid the infection of other people during the therapy, a pronounced hygiene is very important:

• Wash your hands thoroughly with soap after every contact with patients: this is how the bacteria are killed.
• Short-cut and clean fingernails: This prevents skin injuries and the rubbing-in of germs.
• Do not touch or scratch the wounds and crusts to prevent the spread of bacteria.
• Towels, sheets and other textiles that have come into contact with the person concerned, wash at 60 degrees in the washing machine. This kills the bacteria.

Children with Eiterflechte should also be released from the visit to the kindergarten or school.

Impetigo contagiosa: disease course and prognosis

As a rule, the prognosis for impetigo contagiosa is good. If the therapy is carried out consistently, the disease heals without scars or other lasting damage.

In rare cases, the following complications may occur:

• Inflammation of deeper layers of the skin or soft tissue to which the pathogens have spread
• localized lymphadenopathy and lymph node swelling (regional lymphangitis and lymphadenitis)
• Blood poisoning (sepsis)
• purulent conjunctivitis (conjunctivitis)
• Middle ear infection (otitis media)

A rare but serious complication of streptococcal impetigo contagiosa is nephritis. For this reason, a urinalysis (urinalysis) is usually performed at the beginning of the therapy and six weeks after completion of the therapy. In most cases, the kidney inflammation occurs only after the symptoms of impetigo contagiosa have subsided again.

In order to be able to treat complications early, you should definitely consult the doctor again for the following symptoms:

• when the scab spreads, further reddened and inflamed
• if the scab does not heal after three days of treatment
• when fever occurs
• if you experience unwellness, shortness of breath, rash, swelling, itching or stomach pain after taking the medication

If complications are detected early and treated in time, sufferers continue to have a good prognosis, and the Impetigo contagiosa completely heals along with complications.