Treatment Guideline Chart
Impetigo is a very contagious, superficial, bacterial skin infection that easily spreads among people in close contact.
Most cases resolve spontaneously without scarring in approximately 14 days without treatment.
Ecthyma is deeply ulcerated form of impetigo that extends to the dermis. The ulcers are "punched-out" with yellow crust and elevated violaceous margins.
It may be an infection de novo or a superinfection.

Impetigo & Ecthyma (Pediatric) References

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  2. Cole C, Gazewood J. Diagnosis and treatment of impetigo. Am Fam Physician. 2007 Mar;75(6):859-864. PMID: 17390597
  3. Habif TP. Bacterial Infections. Clinical dermatology: A color guide to diagnosis and therapy. 4th ed. Pennsylvania: Mosby, Elsevier; 2004
  4. Morelli JG. Cutaneous bacterial infections. In: Kliegman RM, Behrman RI, Jenson HB, et al, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
  5. Swartz MN, Pasternack MS. Cellulitis and superficial infections. In: Mandell GL, Douglas RB, Bennett JE, et al. Principles and practice of infectious diseases. 6th ed. Philadelphia: Churchill Livingstone, Elsevier; 2005
  6. Ferri FF. Impetigo. In: Alvero R, Borkan JM, Dobbs MR, et al, eds. Ferri’s Clinical Advisor. 1st. Philadelphia: Mosby Inc, an affiliate of Elsevier; 2010.
  7. MedWorm
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  10. Baddour LM. Impetigo. UpToDate. Nov 2012. Accessed 19 Jul 2013
  11. CKS. Impetigo. Clinical Knowledge Summaries. 2006
  12. Rashid RM. Impetigo. eMedicine. Apr 2008
  13. Ratz J. Impetigo. eMedicine.
  14. National Institute for Health and Care Excellence (NICE). Impetigo-Summary. NICE. Jun 2009. Accessed 19 Jul 2013.
  15. Craft N. General consideration of bacterial diseases. In: Wolff K, Goldsmith LA, Katz SI, Glichrest BA, Paller AS, Leffell DJ. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill Companies; 2012.
  16. Paller A, Mancini AJ. Hurwitz Clinical Pediatric Dermatology. A Textbook of Skin Disorders of Childhood and Adolescence. 3rd ed. Chicago: Elsevier Saunders; 2006.
  17. Oakley A. Management of impetigo. Best Practice Advocacy Centre website. Feb 2009.
  18. Baddour L. Impetigo. UpToDate. 14 Oct 2020.
  19. Gahlawat G, Tesfaye W, Bushell M, et al. Emerging treatment strategies for impetigo in endemic and nonendemic settings: A systematic review. Clin Ther. 2021 Jun;43(6):986-1006. doi: 10.1016/j.clinthera.2021.04.013. PMID: 34053699
  20. Hartman-Adams H, Banvard C, Juckett G. Impetigo: diagnosis and treatment. Am Fam Physician. 2014 Aug;90(4):229-235. PMID: 25250996
  21. Ministry of Health Singapore. Infection prevention guidelines for schools (primary) and child care centres. 3rd edition. MOH (Singapore).
  22. Watkins R, David MZ. Approach to the patient with a skin and soft tissue infection. Infect Dis Clin North Am. 2021 Mar;35(1):1-48. doi: 10.1016/j.idc.2020.10.011. PMID: 33494872
  23. Yee GK, Seong HC, Tark K, et al. Clinical guidelines for the antibiotic treatment for community-acquired skin and soft tissue infection. Infect Chemother. 2017 Dec;49(4):301-325. doi: 10.3947/ic.2017.49.4.301. PMID: 29299899
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