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Bullous Impetigo
Aka: Bullous Impetigo
- See Also
- NonBullous Impetigo
- Epidemiology
- Represents 10-30% of Impetigo cases
- Affects infants (esp. newborns) and young children
- Less contagious than NonBullous Impetigo
- Most common cause of ulcerative buttock rash in infants
- Pathophysiology
- Unlike NonBullous Impetigo, Bullous Impetigo is caused only by staphyococcus aureus
- Staphylococcal toxin-mediated reaction
- Staphylococcal Infection with Phage Group 2
- Local variant of Staphylococcal Scalded Skin Syndrome
- Symptoms: Systemic symptoms in less typical cases
- Fever
- Diarrhea
- Weakness
- Signs
- Distribution
- Intertriginous areas (diaper, axilla, neck)
- Characteritics
- Onset with vessicles enlarging quickly to bullae
- Flaccid bullae, 1-2 cm diameter with sharp margins
- No surrounding erythema (unlike nonbullous form)
- Bullae break leaving characteristic appearance
- Thin yellow serous crust
- Small rim of Blister roof at edge of lesion
- Pathognomonic Signs (Collarette Sign)
- Collar of scale forms around ruptured Blister roof
- Differential Diagnosis
- Common
- Contact Dermatitis
- Herpes Simplex Virus
- Varicella
- Insect Bites
- Burn Injury (e.g. Cigarette burns)
- Uncommon
- Bullous variants of other conditions
- Erythema Multiforme
- Systemic Lupus Erythematosus
- Scabies
- Fixed Drug Eruption
- Stevens-Johnson Syndrome
- Bullous Pemphigoid
- Pemphigous vulgaris
- Dermatitis Herpetiformis
- Management
- See Impetigo
- Course
- Self-limited, non-scarring
- Resolves within 2-3 weeks
- References
- Cole (2007) Am Fam Physician 75(6):859-68 [PubMed]
- Brown (2003) Int J Dermatol 42:251-5 [PubMed]