Impetigo - 膿痂疹
顎の膿痂疹の症例。小さな子供に外傷の病歴はないが、傷のような病変が広がっている場合は、膿痂疹を疑う必要があります。
アトピー性皮膚炎とは異なり、膿痂疹は抗生物質による治療が必要であり、ステロイドの使用により悪化する可能性があります。
relevance score : -100.0%
ReferencesImpetigo（伝染性膿痂疹）は、2〜5歳の子どもに最も多い細菌性皮膚感染症で、非水疱型（全症例の約70％）と水疱型（約30％）の2つに大別されます。非水疱型は主にStaphylococcus aureusまたはStreptococcus pyogenesが原因です。顔や四肢に黄色っぽいかさぶたができ、皮膚そのものだけでなく、虫刺され、湿疹、ヘルペス病変にも感染します。水疱型はS. aureus単独が原因で、大きく柔らかい水疱ができ、皮膚がこすれ合う部位に多く見られます。どちらも通常2〜3週間で瘢痕を残さず自然に治癒し、合併症は稀です。最も重篤な合併症は溶連菌感染後腎炎です。治療は局所抗生物質（mupirocin、retapamulin、fusidic acid）を使用します。大きな水疱がある場合や局所治療が困難な場合は経口抗生物質が必要になることがあります。使用できる経口抗生物質にはamoxicillin/clavulanate、dicloxacillin、cephalexin、clindamycin、doxycycline、minocycline、trimethoprim/sulfamethoxazole、マクロライド系がありますが、penicillinは効果がありません。局所消毒剤は抗生物質ほど有効ではなく、使用は避けるべきです。fusidic acid、mupirocin、retapamulinはメチシリン感受性S. aureusおよび溶連菌に有効です。clindamycinはメチシリン耐性S. aureusが疑われる場合に有用です。trimethoprim/sulfamethoxazoleはメチシリン耐性S. aureusに対して効果がありますが、溶連菌感染には不十分です。
Impetigo, the most common bacterial skin infection in children aged two to five, comes in two main types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo is typically caused by Staphylococcus aureus or Streptococcus pyogenes. It's recognized by honey-colored crusts on the face and limbs and mainly targets the skin or can infect insect bites, eczema, or herpetic lesions. Bullous impetigo, caused solely by S. aureus, leads to large, flaccid bullae and often affects areas where skin rubs together. Both types usually clear up within two to three weeks without scarring, and complications are rare, with poststreptococcal glomerulonephritis being the most severe. Treatment involves topical antibiotics (mupirocin, retapamulin, fusidic acid). Oral antibiotics might be necessary for impetigo with large bullae or when topical treatment isn't feasible. While several oral antibiotics (amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, macrolides) are options, penicillin isn't effective. Topical disinfectants aren't as good as antibiotics and should be avoided. Fusidic acid, mupirocin, retapamulin are effective against methicillin-susceptible S. aureus and streptococcal infections. Clindamycin is useful for suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole works against methicillin-resistant S. aureus, but isn't enough for streptococcal infection.
Impetigo, the most common bacterial skin infection in children aged two to five, comes in two main types: nonbullous (70% of cases) and bullous (30% of cases). Nonbullous impetigo is typically caused by Staphylococcus aureus or Streptococcus pyogenes. It's recognized by honey-colored crusts on the face and limbs and mainly targets the skin or can infect insect bites, eczema, or herpetic lesions. Bullous impetigo, caused solely by S. aureus, leads to large, flaccid bullae and often affects areas where skin rubs together. Both types usually clear up within two to three weeks without scarring, and complications are rare, with poststreptococcal glomerulonephritis being the most severe. Treatment involves topical antibiotics (mupirocin, retapamulin, fusidic acid). Oral antibiotics might be necessary for impetigo with large bullae or when topical treatment isn't feasible. While several oral antibiotics (amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, macrolides) are options, penicillin isn't effective. Topical disinfectants aren't as good as antibiotics and should be avoided. Fusidic acid, mupirocin, retapamulin are effective against methicillin-susceptible S. aureus and streptococcal infections. Clindamycin is useful for suspected methicillin-resistant S. aureus infections. Trimethoprim/sulfamethoxazole works against methicillin-resistant S. aureus, but isn't enough for streptococcal infection.
Impetigoは、特定の細菌が原因の一般的な皮膚感染症で、接触により容易に広がります。典型的には、黄色がかったかさぶたで覆われた赤い斑点として現れ、かゆみや痛みを伴うことがあります。この感染症は、暖かく湿度の高い地域に住む子供に最も多く見られます。水疱ができることもあれば、できないこともあります。顔にできやすいですが、皮膚に傷がある部位ならどこでも発生し得ます。診断は主に症状と外観で行われます。治療は、局所および経口の抗生物質投与と、症状緩和を中心に行います。
Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. It most commonly presents as erythematous plaques with a yellow crust and may be itchy or painful. The lesions are highly contagious and spread easily. Impetigo is a disease of children who reside in hot humid climates. The infection may be bullous or nonbullous. The infection typically affects the face but can also occur in any other part of the body that has an abrasion, laceration, insect bite or other trauma. Diagnosis is typically based on the symptoms and clinical manifestations alone. Treatment involves topical and oral antibiotics and symptomatic care.
Impetigo is a common infection of the superficial layers of the epidermis that is highly contagious and most commonly caused by gram-positive bacteria. It most commonly presents as erythematous plaques with a yellow crust and may be itchy or painful. The lesions are highly contagious and spread easily. Impetigo is a disease of children who reside in hot humid climates. The infection may be bullous or nonbullous. The infection typically affects the face but can also occur in any other part of the body that has an abrasion, laceration, insect bite or other trauma. Diagnosis is typically based on the symptoms and clinical manifestations alone. Treatment involves topical and oral antibiotics and symptomatic care.
膿痂疹 (impetigo) は通常、黄色ブドウ球菌または化膿性連鎖球菌のいずれかが原因です。接触すると、周囲の人へ感染が広がる可能性があります。子どもでは兄弟にも伝染しやすいです。
治療には、通常、Mupirocin（ムピロシン）やFusidic acid（フシジン酸）などの抗生物質クリームを使用します。広範囲に及ぶ場合は、Cefalexin（セファレキシン）などの経口抗生物質が投与されることがあります。
膿痂疹 (impetigo) は、2010 年に約1億4,000万人（世界人口の約2%）に影響を及ぼしました。どの年齢でも発症しますが、特に幼児に多く見られます。合併症として蜂窩織炎や連鎖球菌後糸球体腎炎が起こることがあります。
○ 治療 ― OTC医薬品
※膿痂疹は感染症ですので、ステロイド軟膏は使用できません。膿痂疹と湿疹の区別が難しい場合は、ステロイド軟膏を使用せず、市販の抗ヒスタミン薬を服用してください。
#OTC antihistamine
※市販の抗生物質軟膏を患部に塗布してください。
#Bacitracin
#Polysporin