Impetigo contagiosa, small vesicles L01.0

More frequent form Impetigo contagiosa with small, rapidly bursting blisters and pustules. Mostly caused by streptococci (see also pyoderma).

Mostly hemolyzing streptococci; rarely staphylococci.

Frequently beginning under the nose, initially small red spots. Transition to glass pinhead-sized, tight, water-clear, rapidly bursting blisters and pustules. In the foreground of the clinical picture are bean to coin-sized, often itchy and weeping, crusty lesions with strong exudation. Circinary disease foci due to peripheral progression. Central scarless healing.

Remember.

• Cover affected areas of skin with a gauze or with an adapted tubular bandage (to avoid the transmission of bacteria through the scratching finger). Do not use a plaster for fastening. It is best to soften crusts with ointments or soft pastes (e.g. 2% Clioquinol titanium oxide paste R053 ), if necessary with disinfectant solutions such as quinolinol solution(e.g. Chinosol 1:1000) or R042 or polihexanide (Serasept, Prontoderm). Instead of Clioquinol ointment, a 2% quinolinol ointment (alternatively: polyvidon iodine ointment such as Betaisodona, R204 ) or a disinfecting soft zinc paste (beneficial for infestation of intertriginous areas) can be chosen. Local antibiotics have proven to be effective, e.g. Infectopyoderm, Fucidine, Refobacin.
• Change dressing twice a day: Put on gloves, dab the flock with pure olive oil, gently remove crusts, open pustules and blisters with a cannula, treat again with ointments. Disinfecting baths are beneficial for the healing process (e.g. with quinosol 1:1000, potassium permanganate (light pink) or polyvidon iodine solution).

Antibiotics are unavoidable in large herds. They are usually administered after an antibiogram (however, if the clinical picture is clear, an oral cephalosporin can be started spontaneously), the therapy of choice being oral cephalosporins (cephaclor, cephaloxin) or penicillinase-resistant penicillins (flucloxacillin, dicloxacillin). For penicillin allergy is Clindamycin (20-30mg/kgKG).

Preparations and dosages see below impetigo. In case of itching a sedative antihistamine is recommended, e.g. clemastine (e.g. Tavegil syrup 2-4 teaspoons/day), Dimetinden (e.g. Fenistil syrup 3-6 teaspoons) or the non-sedative Desloratadine (e.g. Aerius syrup 1/2-1 measuring spoon). The substances are available in an application form suitable for children (juices).

In case of itching a sedative antihistamine is recommended, e.g. Clemastine (e.g. Tavegil Syrup 2-4 teaspoons/day), Dimetinden (e.g. Fenistil Syrup 3-6 teaspoons) or the non-sedative Desloratadine (e.g. Aerius Syrup 1/2-1 measuring spoon).

The form described here as the "small-bubble form" of impetigo is described in Anglo-American literature as "non-bullous impetigo". This is justified insofar as the initial vesicles of the small-bubble form are often not observed. The clinical picture impresses with weeping crusts, which are often described as "honey yellow".