Download PBL Part 1- Team 8

PBL Part 1: Team 8 (Erazors)
As a group we have chosen to focus on Mele and discuss the treatment for impetigo and how to
minimize its spread and included in our discussion is how you differentiate between scabies and
impetigo. This was our most significant piece of learning because we have not had exposure in
learning impetigo and scabies before. We have also provided a useful website at the end of this
summary which we found helpful in our learning.
MELE
Action point
What is the treatment for impetigo and how do you minimize spread? Include in the discussion
how you differentiate between impetigo and scabies.
Impetigo is a common skin infection. It is most common in children, particularly children in
unhealthy living conditions. . It is often called “school sores” because it is common in school
children and it spreads amongst them quite easily. In adults, it may follow other skin disorders.
Impetigo may follow a recent upper respiratory infection such as a cold or other viral infection.
It is similar to cellulitis, but is more superficial, involving infection of the top layers of the skin
with streptococcus (strep), staphylococcus (staph), or both.
What is the treatment for impetigo?

treatment depends on how far the impetigo has spread and how severe it is

your doctor may prescribe either an antibiotic or antiseptic ointment applied to the
affected area or antibiotics taken by mouth (or both)

if antibiotic medicine is prescribed, give it to your child as recommended by your doctor;
it is important to finish the full course of medical treatment, even if the sores have healed

gently clean the crusts or oozing sores by soaking a clean cloth in a solution and
applying to your child’s sores several times a day; you can make up one of the following
solutions:
- half a cup of white vinegar in a litre of warm water
- soap and warm water
- half a teaspoon of salt in a cup of warm water
Alternatively, you can use an antiseptic solution such as Savlon or Dettol (follow the
directions for making the solution on the bottle)

try to prevent your child scratching the sores as much as possible; cutting your child’s
fingernails can help prevent damage and infection from scratching

cover sores with a watertight dressing to prevent the infected fluid and crusts from
spreading

using an antiseptic soap may prevent the infection spreading to other parts of the body
Impetigo should clear up in a few days with treatment but may need to be treated again if the
sores recur.
PBL Part 1: Team 8 (Erazors)
How to minimise the spread of impetigo?
Keep your child home from school, kindergarten or day care until they have had 24 hours of
treatment. Make sure their sores are completely covered by dressings.
Your child should avoid swimming until all the sores have healed.
Wash your child’s clothes, towels and bed linen separately from the rest of the family. Wash
them in hot water and dry in the sunshine or a hot tumble dryer. Toys can be washed using a
mild disinfectant.
The following measures may also reduce the risk of impetigo:

taking a daily bath or shower with soap and water

using antiseptic soaps (although these can irritate the skin of some people)

practicing good hygiene - wash hands regularly (especially important if you are in
contact with someone with impetigo), throw away used tissues

putting all dressings in a bin with a lid as soon as they are taken off

cutting your child’s fingernails short and keep them clean

thoroughly washing grazes or cuts; if your child is scratching a sore, cover it with a
dressing
Key points to remember about impetigo

impetigo is a common skin infection in children caused by bacteria

impetigo is very contagious (catching) and can be easily spread to other children

try to prevent your child scratching the sores as much as possible; cover sores with a
watertight dressing and cut your child’s fingernails

your child can go back to school, kindergarten or day care after 24 hours of treatment
and when the sores are completely covered with dressings

continue medical treatment until all sores are healed
PBL Part 1: Team 8 (Erazors)
What are the signs and symptoms
of impetigo?

the sores can be anywhere on the body,
but most often occur on exposed areas
such as the face (near the mouth and
nose), or on the hands, arms or legs

impetigo usually starts with a blister or a group of blisters

the blister bursts leaving a patch of red, wet skin which weeps or oozes

the spot usually becomes coated with a tan or yellowish crust, making it look like it has
been covered with honey; it grows larger day by day

there can be small spots around the first spots, spreading outwards

impetigo is usually itchy
How is impetigo spread?

the fluid and crusts of the sore contain the bacteria

infection can easily spread to other parts of your child’s body when they touch or scratch
their sore; the bacteria can also be spread from parts of the body that do not appear to
be affected, such as from a runny nose

infection can also easily spread to others by:
- direct skin contact
- contact with infected clothing, towels, sponges or face-cloths
- frequently handled playthings and utensils that are infected

a sore can be infectious as long as it is weeping or oozing

usually a sore has stopped being infectious about 24 hours after antibiotic treatment has
been started, and healing has begun
PBL Part 1: Team 8 (Erazors)
When should I seek help for impetigo?
You should see your GP (general practitioner) as soon as you suspect your child has impetigo.
If treated promptly, impetigo is not usually a serious infection but untreated impetigo can lead to
serious illness.
Go back to your GP if you have started treatment and:

the sores do not begin to heal within two days

more sores develop

redness spreads around a sore

your child is unwell with a fever or you are worried about their symptoms
How to differentiate between impetigo and scabies:
Impetigo

Impetigo often starts at the site of a minor skin injury such as a graze, an insect bite or
scratched eczema,

Transmission o Impetigo is most commonly caused by Staphylococcus aureus and
Streptococcus

pyogenes.3

Impetigo generally presents with pustules and round, oozing patches which increase in
size each day. There may be clear blisters, which rupture to form a golden yellow crust.
It most often occurs on exposed areas such as the face and hands, or in skin folds,
particularly the axillae.
Treatment

Impetigo, topical treatment is recommended initially. Fusidic acid cream applied for
seven days is a suitable choice.9 Crusts should be gently removed before applying the
cream.

Oral antibiotics should be used for extensive disease or systemic infection or when
topical treatment fails.

Flucloxacillin for seven days is a suitable choice as it is effective against S. aureus and
S. pyogenes
PBL Part 1: Team 8 (Erazors)
Scabies

The underlying reason is close body-to-body contact

Transmission of the scabies mite (Sarcoptes scabiei) usually occurs via close skin-toskin contact with an infected person

Scabies infection produces intense pruritus, especially on the trunk and limbs, and at
night. There are usually limited visible signs of the infestation but burrows may
sometimes be observed on the wrists, finger web spaces or the sides and soles of the
feet. Complaints of intense pruritus should raise a suspicion of scabies, especially if
there is a family report of similar symptoms.
Treatment

Scabies will not resolve spontaneously without treatment.

Permethrin appears to be the most effective topical

Scabicide.12 Malathion lotion may also be considered.

Topical gamma benzene hexachloride (Lindane or Benhex) has been used in the past
but is now not recommended due to toxicity concerns.13
The following reference below is the website that we found useful as a group in learning
the differences between impetigo and scabies and its treatment options.
Reference:
Best Practice Journal. (2009). Skin Infections in Pacific peoples. Retrieved on July
28, 2011, from
http://www.bpac.org.nz/magazine/2010/november/infectious.asp?section=4