Pathophysiology
Respond 1
Impetigo
The purpose of this discussion is to review impetigo. Impetigo can be mistaken for other skin conditions such as herpes simplex. Therefore, it is necessary to accurately identify what it is. Impetigo is a skin disorder that is superficial in nature. It can spread from person to person and on other parts of the body (Centers for Disease Control and Prevention [CDC], 2020).
Pathophysiology
The main form of transmission is direct contact. The infection is caused by bacteria (CDC, 2020). Staphylococcus aureus is the main causative agent in older children. Group A beta-hemolytic streptococci also causes impetigo (Hubert & VanMeter, 2018). Interruption in the skin barrier allows the bacteria to access fibronectin receptors in the skin, which is needed for colonization (Nardi & Schaefer, 2020). Infection is further spread by itching due to the irritable nature of the lesions. Autoinoculation with hand creates more vesicles (Hubert & VanMeter, 2018).
The Most Common Presenting Symptoms
Impetigo can be found on any part of the body (CDC, 2020). However, it is mostly seen on the face (Hubert & VanMeter, 2018). Small red vesicles quickly become larger. The vesicles break open and forms a yellowish-brown crust. Liquid with honey colored appearance is seen under the crusts (Hubert & VanMeter, 2018).
Routinely Diagnosed
Impetigo is diagnosed by initial observation of an abnormality in the skin during a physical exam. The diagnosis can be confirmed with a bacterial culture, especially if there is an epidemic or if methicillin-resistant staph aureus (MRSA) is a concern. A biopsy of the skin can be obtained in some cases of untreatable impetigo (Nardi & Schaefer, 2020). Serologic testing for streptococcus antibodies is not done since anti-streptolysin O (ASO) response is not strong enough for diagnosing impetigo in this manner. Nonetheless, it can be used in conditions where
post-streptococcal glomerulonephritis is questioned for patients who had a new outbreak of impetigo (Nardi & Schaefer, 2020). Otherwise lab testing is not needed (CDC, 2020).
