Impetigo physical examination: Difference between revisions

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Revision as of 16:41, 17 April 2017

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:

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
Inguinal lymphadenopathy

Cardiovascular

Tachycardia

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

References

↑ ^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.
↑ Cole C, Gazewood J (2007). "Diagnosis and treatment of impetigo". Am Fam Physician. 75 (6): 859–64. PMID 17390597.
↑ Adams BB (2002). "Dermatologic disorders of the athlete". Sports Med. 32 (5): 309–21. PMID 11929358.
↑ ^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".
↑ "Public Health Image Library (PHIL)".

Template:WH Template:WS

[pmid27458596-1] 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.

[pmid17390597-2] Cole C, Gazewood J (2007). "Diagnosis and treatment of impetigo". Am Fam Physician. 75 (6): 859–64. PMID 17390597.

[pmid11929358-3] Adams BB (2002). "Dermatologic disorders of the athlete". Sports Med. 32 (5): 309–21. PMID 11929358.

[Dermatology_Atlas-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".

[PHIL-5] "Public Health Image Library (PHIL)".

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@@ Line 7: / Line 7: @@
 ==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
 **Fluid filled [[bullae]]