Impetigo: The Daily PANCE Blueprint

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Impetigo: The Daily PANCE Blueprint

A 5-year-old male presents to the clinic with his mom due to a “tender rash on his face.” On physical exam, you note scattered thin-roofed vesicles around his nose and mouth, as well as a yellowish-orange colored crust around his nares. Which of the following is the most likely diagnosis?

A. Impetigo
B. Bullous pemphigoid
C. Hand, foot, and mouth disease
D. Varicella virus
E. Contact dermatitis

Answer and topic summary

The answer is A. Impetigo 

Impetigo is a very common skin infection of the skin typically in children. There are two main types: nonbullous (MC) and bullous. Impetigo can be caused by Staphylococcus aureus or group A Streptococcus (aka Streptococcus pyogenes). A classic presentation is a honey-colored crust on the face. Remember though that with bullous impetigo, patients will usually have large, flaccid bullae in intertriginous areas. Topical antibiotics are the preferred treatment (mupirocin). When topical therapy is not adequate or unreasonable, then oral antibiotics can be given (e.g., augmentin, cephalexin, doxycycline, etc).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Dermatology ⇒ Dermatologic Infectious diseases (PEARLS) ⇒ Bacterial Infections ⇒ Impetigo

Also covered on the Family Medicine EOR, Emergency Medicine EOR, and Pediatric rotation content topic list