Infantile Impetigo: A Comprehensive Review of Dermatologic and Pediatric Considerations.

Abstract

Impetigo is a common and highly contagious bacterial skin infection that mainly affects children around the world. It is characterized by skin lesions, including pustules, vesicles and crusts, often accompanied by itching and discomfort. Studies on the epidemiology of impetigo point to significant variations in the prevalence of impetigo in different geographic regions and age groups. This bacterial infection mainly affects low-income children, affecting more than 2% of the global population, being more prevalent in tropical and subtropical areas, with Oceania standing out as the region with the highest incidence. Impetigo can be divided into two main clinical manifestations: bullous impetigo and non-bullous impetigo. Bullous impetigo is predominantly caused by Staphylococcus aureus and is characterized by flaccid, transparent blisters that develop in the subcorneal layer of the skin. These blisters usually appear in intertriginous regions such as diaper areas, armpits, neck and palms and soles. Non-bullous impetigo is more common and can be primary, resulting from bacterial invasion of intact skin, or secondary, resulting from infection through non-intact skin. The main cause is Staphylococcus aureus, often associated with group A beta hemolytic streptococci. The diagnosis of impetigo is usually made clinically, but laboratory tests, such as culture of fluid from vesicles, pustules, or areas below the edges of crusted plaques, can be used for confirmation. Impetigo is differentiated from other conditions through tests such as a negative Nikolsky sign. Treatment of impetigo involves maintaining antisepsis of the lesions and the use of topical antibiotics, such as fusidic acid, retapamulin and mupirocin, which are effective for localized lesions. Furthermore, for more extensive cases of the disease it is necessary to use systemic antibiotics, and should always choose those with less susceptibility to bacterial resistance.