Bullous impetigo is a blistering eruption caused by Staphylococcus aureus.
The earliest lesion is a vesicle, which rapidly evolves into a bulla. Satellite and more distant lesions can appear as small or large bullae, usually surrounded by some erythema. The bullae rupture, leaving eroded areas, surrounded by a rim of desquamating epidermis.
Generalized bullous impetigo is known as the Staphylococcal scalded skin syndrome.
The diagnosis can be confirmed by a Gram-stain of the vesicle contents in which are seen white blood cells and plump Gram-positive cocci in clumps.
- Bullous impetigo is staphylococcal in origin, and treatment should be directed towards that organism.
- Effective topical agents include mupirocin and fusidic acid* ointment or cream, as well as systemic antibiotics directed at staphylococci. In most instances of localized involvement, topical therapy alone is adequate.