Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Superficial pyodermaStreptococcal impetigoImpetigo contagiosa ++ 041.01 Streptococcus infection in conditions classified elsewhere and of unspecified site, Streptococcus, group A ++ B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere ++ 7B: Impaired Integumentary Integrity Secondary to Superficial Skin Involvement +++ Description ++ Streptococcus pyogenes (group A Streptococcus) is responsible for infections in the skinHighly infectious skin rash, spreads rapidlyIt occurs most often in tropical climates or during the summer months in non-tropical climatesWith this infection, the patient is usually afebrile and has no pain.Lesions are most often on the face and extremities and may become a mild but chronic illness if untreatedMost common in children, particularly those in unhealthy living conditionsIn adults, it may follow other skin disorders or a recent upper respiratory infection, such as a cold or other virusPreceding a streptococcal respiratory infection +++ Essentials of Diagnosis ++ Diagnosis is usually made by considering medical history and signs and symptoms, including the distinctive soresA culture may be used to confirm the diagnosis or to rule out another cause +++ General Considerations ++ Highly contagious and can be spread through close contact or sharing itemsScratching can spread the sores to other parts of the bodyIt can be difficult to distinguish clinically between skin infection caused by streptococci and other bacteria such as Staphylococcus +++ Demographics ++ Highest prevalence in children 2 to 5 years of ageCan be seen in adults, but is more prevalent in children +++ Signs and Symptoms ++ ImpetigoErysipelasRashBlisters filled with pusFeverMalaiseVomiting: childhood typeItching blisterErythematous denuded areasHoney-colored crustsLocalized area of rednessPurulent vesicles covered with a thick, confluent, honey-colored fluidSwollen lymph nodes near the infectionLesions most often on face, lips, arms, and legs +++ Functional Implications ++ Very contagious, limiting contact and social status +++ Possible Contributing Causes ++ Skin lesionsCirculation impairmentPainEdemaContact with someone with the skin infection +++ Differential Diagnosis ++ TineaHerpetic impetigoPemphigus vulgarisPemphigus foliaceusFolliculitisPseudomonas folliculitisFollicular mucinosisErysipelasLymphadenitisLymphadenopathyS. aureus infectionInsect bites +++ Laboratory Tests ++ Culture of the skin or lesionBlood cultures: leukocytosis tests +++ Medication ++ Parental antibioticsPenicillinCefazolin ++ Allergist/immunologistDermatologist ++ Skin integrityCirculationPainSensationJoint ROMMuscle strengthFunctional mobilitySelf-careHome management ++ Integumentary integrityPigmentationShape and size of skin involvementPresence of rash, fungi, blistering, ecchymosis, hair growth, signs of infectionSkin temperatureTissue ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.