Impetigo physical examination: Difference between revisions

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==Overview==
==Overview==
The diagnosis of impetigo is primarily clinical. A thorough physical examination plays an important role in the diagnosis of impetigo along with a detailed history taking.<ref name="pmid27458596">{{cite journal| author=Duggal SD, Bharara T, Jena PP, Kumar A, Sharma A, Gur R et al.| title=Staphylococcal bullous impetigo in a neonate. | journal=World J Clin Cases | year= 2016 | volume= 4 | issue= 7 | pages= 191-4 | pmid=27458596 | doi=10.12998/wjcc.v4.i7.191 | pmc=4945591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27458596  }} </ref><ref name="pmid17390597">{{cite journal| author=Cole C, Gazewood J| title=Diagnosis and treatment of impetigo. | journal=Am Fam Physician | year= 2007 | volume= 75 | issue= 6 | pages= 859-64 | pmid=17390597 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17390597  }} </ref>
The diagnosis of impetigo is primarily clinical. A thorough physical examination plays an important role in the diagnosis of impetigo along with a detailed history taking.Bullae, [[papules]], [[pustules]] or [[ulcers]] may be visible depicting various types of impetigo.<ref name="pmid27458596">{{cite journal| author=Duggal SD, Bharara T, Jena PP, Kumar A, Sharma A, Gur R et al.| title=Staphylococcal bullous impetigo in a neonate. | journal=World J Clin Cases | year= 2016 | volume= 4 | issue= 7 | pages= 191-4 | pmid=27458596 | doi=10.12998/wjcc.v4.i7.191 | pmc=4945591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27458596  }} </ref><ref name="pmid17390597">{{cite journal| author=Cole C, Gazewood J| title=Diagnosis and treatment of impetigo. | journal=Am Fam Physician | year= 2007 | volume= 75 | issue= 6 | pages= 859-64 | pmid=17390597 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17390597  }} </ref>


==Physical Examination==
==Physical Examination==
The follwoing findings on physical examination may suggest impetigo:<ref name="pmid27458596">{{cite journal| author=Duggal SD, Bharara T, Jena PP, Kumar A, Sharma A, Gur R et al.| title=Staphylococcal bullous impetigo in a neonate. | journal=World J Clin Cases | year= 2016 | volume= 4 | issue= 7 | pages= 191-4 | pmid=27458596 | doi=10.12998/wjcc.v4.i7.191 | pmc=4945591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27458596  }} </ref>
The follwoing findings on physical examination may suggest impetigo:<ref name="pmid27458596">{{cite journal| author=Duggal SD, Bharara T, Jena PP, Kumar A, Sharma A, Gur R et al.| title=Staphylococcal bullous impetigo in a neonate. | journal=World J Clin Cases | year= 2016 | volume= 4 | issue= 7 | pages= 191-4 | pmid=27458596 | doi=10.12998/wjcc.v4.i7.191 | pmc=4945591 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27458596 }} </ref><ref name="pmid11929358">{{cite journal| author=Adams BB| title=Dermatologic disorders of the athlete. | journal=Sports Med | year= 2002 | volume= 32 | issue= 5 | pages= 309-21 | pmid=11929358 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11929358 }} </ref>
*Bullous impetigo
*Bullous impetigo
**Fluid filled bullae
**Fluid filled [[bullae]]
**Bullae are flaccid and a thin brown crust is visible after they rupture
**[[Lesions]] are [[flaccid]] and present as a rim of thin brown crust after rupture
**Bullous impetigo can usualy be seen on the trunk
**Bullous impetigo can usualy be seen on the trunk
*Non-bullous impetigo
*Non-bullous impetigo
**Papules
**[[Papules]]
**Pustules
**[[Pustules]]
**Vesicles
**[[Vesicles]]
**Non-bullous impetigo is usually seen on the extremities and face
**Non-bullous impetigo is usually seen on the extremities and face
**Brown crust may be seen after rupture
**Complete brown crust may be seen after rupture
*Ecthyma
*Ecthyma
**Ulcers are punched-out with raised borders
**[[Ulcers]] are punched-out with raised borders
**Brown crust can be seen on the ulcer
**Brown crust can be seen on the [[ulcer]]
 
===General Appearance ===
*Patients with impetigo are usually not in distress
*Patients may appear fatigued
===Vital Signs===
The following vital signs may be noticed in impetigo:
 
*[[Fever]] may be present
*[[Blood pressure]] is normal
*[[Hypotension]]
 
===Abdomen===
*[[Rash]] may be visible on the [[abdomen]]
 
===Trunk and Extremities===
*[[Rash]] may be seen on the trunk or extremities
*Enlarged [[axillary lymph nodes]]
 
===Genitourinary===
The following findings may be found on genitourinary examination of a patient with impetigo:
 
*[[Rash]] on the [[genitals]]
*[[Dysuria]] in case the rash is rash involving the skin around the [[urethra]]
*[[Lymphadenopathy|Inguinal lymphadenopathy]]
 
===Cardiovascular===
*[[Tachycardia]]
 
===Neurological===
There are usually no neurological findings in a patient with impetigo.
 
==Gallery==
==Gallery==
 
Given below are some exmples of impetigo on various skin locations.
====Skin====
====Skin====
=====Face=====
=====Face=====
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{{Reflist|2}}
{{Reflist|2}}


[[Category:Infectious disease]]
 
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[[Category:Disease]]
[[Category:Disease]]
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[[Category:Bacterial diseases]]
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[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Needs content]]
[[Category:Needs content]]
[[Category:Primary care]]
[[Category:Emergency mdicine]]
 
[[Category:Up-To-Date]]
{{WH}}
[[Category:Infectious disease]]
{{WS}}
[[Category:Gynecology]]
[[Category:Urology]]

Latest revision as of 22:21, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2], Usama Talib, BSc, MD [3]

Overview

The diagnosis of impetigo is primarily clinical. A thorough physical examination plays an important role in the diagnosis of impetigo along with a detailed history taking.Bullae, papules, pustules or ulcers may be visible depicting various types of impetigo.[1][2]

Physical Examination

The follwoing findings on physical examination may suggest impetigo:[1][3]

  • Bullous impetigo
    • Fluid filled bullae
    • Lesions are flaccid and present as a rim of thin brown crust after rupture
    • Bullous impetigo can usualy be seen on the trunk
  • Non-bullous impetigo
    • Papules
    • Pustules
    • Vesicles
    • Non-bullous impetigo is usually seen on the extremities and face
    • Complete brown crust may be seen after rupture
  • Ecthyma
    • Ulcers are punched-out with raised borders
    • Brown crust can be seen on the ulcer

General Appearance

  • Patients with impetigo are usually not in distress
  • Patients may appear fatigued

Vital Signs

The following vital signs may be noticed in impetigo:

Abdomen

Trunk and Extremities

Genitourinary

The following findings may be found on genitourinary examination of a patient with impetigo:

Cardiovascular

Neurological

There are usually no neurological findings in a patient with impetigo.

Gallery

Given below are some exmples of impetigo on various skin locations.

Skin

Face
Trunk
Extremity
Ear
Genitalia

References

  1. ↑ 1.0 1.1 Duggal SD, Bharara T, Jena PP, Kumar A, Sharma A, Gur R; et al. (2016). "Staphylococcal bullous impetigo in a neonate". World J Clin Cases. 4 (7): 191–4. doi:10.12998/wjcc.v4.i7.191. PMC 4945591. PMID 27458596.
  2. ↑ Cole C, Gazewood J (2007). "Diagnosis and treatment of impetigo". Am Fam Physician. 75 (6): 859–64. PMID 17390597.
  3. ↑ Adams BB (2002). "Dermatologic disorders of the athlete". Sports Med. 32 (5): 309–21. PMID 11929358.
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 4.37 4.38 4.39 4.40 4.41 4.42 4.43 4.44 4.45 4.46 4.47 4.48 4.49 4.50 4.51 4.52 4.53 4.54 4.55 4.56 4.57 4.58 4.59 4.60 4.61 4.62 4.63 4.64 4.65 4.66 4.67 4.68 4.69 4.70 4.71 4.72 4.73 4.74 4.75 4.76 4.77 "Dermatology Atlas".
  5. ↑ "Public Health Image Library (PHIL)".


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