Impetigo - 膿皰瘡https://en.wikipedia.org/wiki/Impetigo
膿皰瘡 (Impetigo) 是一種牽涉表淺皮膚的細菌感染。最常見的表現是臉部、手臂或腿部出現黃色痂皮。皮損可能會疼痛或發癢,但發燒並不常見。

膿皰瘡 (Impetigo) 通常是由金黃色葡萄球菌或化膿性鏈球菌引起。透過接觸,它可以在人與人之間或人與動物之間傳播。對於兒童而言,常會傳染給兄弟姊妹。

治療通常使用抗生素乳膏,例如莫匹羅星 (mupirocin) 或夫西地酸 (fusidic acid)。如果受累面積較大,可改用口服抗生素,例如頭孢氨芐 (cephalexin)。

2010 年,膿皰瘡 (Impetigo) 影響了約 1.4 億人(佔世界人口的 2%)。併發症可能包括蜂窩性組織炎或鏈球菌感染後的腎絲球腎炎。

治療 - 非處方藥
* 由於膿皰瘡是一種傳染性疾病,應避免使用類固醇藥膏。如果您無法分辨膿皰瘡與濕疹,建議使用非處方抗組織胺藥,切勿使用類固醇藥膏。
#OTC antihistamine

* 請在患處塗抹非處方抗生素藥膏。
#Bacitracin
#Polysporin
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  • 以下是一例下巴膿皰瘡。若小孩無外傷史,但傷口樣病灶持續擴散,應懷疑膿皰病。
  • 推測為異位性皮膚炎患者的繼發性感染。
  • 與異位性皮膚炎不同,膿皰瘡需要使用抗生素治療,且可能因使用類固醇而惡化。
  • 圖示為 bullous impetigo 水泡破裂後的樣子。
  • 可能被誤診為異位性皮膚炎。
  • Bullous impetigo ― 當伴隨薄且脆弱的水泡時,即診斷為 bullous impetigo。
References Impetigo: Diagnosis and Treatment 25250996
Impetigo 是 2 至 5 歲兒童中最常見的細菌性皮膚感染,主要分為兩種類型:非大皰性(約佔 70%)和大皰性(約佔 30%)。非大皰性膿皰病通常由 Staphylococcus aureus 或 Streptococcus pyogenes 引起,其特徵為臉部和四肢出現蜂蜜色結痂,常發生於皮膚受損處,如昆蟲叮咬、濕疹或皰疹病灶。大皰性膿皰病僅由金黃色葡萄球菌(Staphylococcus aureus)引起,會形成大而鬆弛的水皰,且多出現在皮膚相互摩擦的部位。 這兩種類型通常在兩至三週內自行消退,不會留下疤痕,併發症較少,最嚴重的為鏈球菌感染後的腎小球腎炎。治療包括局部使用抗生素(mupirocin、retapamulin、fusidic acid)。若為大皰性膿皰或局部治療無效,則需口服抗生素。常用的口服藥物包括 amoxicillin/clavulanate、dicloxacillin、cephalexin、clindamycin、doxycycline、minocycline、trimethoprim/sulfamethoxazole 以及各類 macrolides,但對青黴素無效。外用消毒劑的效果不如抗生素,應避免使用。 Fusidic acid、mupirocin、retapamulin 可有效對抗對甲氧西林敏感的金黃色葡萄球菌及鏈球菌感染。Clindamycin 對於疑似 methicillin‑resistant Staphylococcus aureus(MRSA)感染特別有用。Trimethoprim/sulfamethoxazole 可對抗甲氧西林耐藥金黃色葡萄球菌(MRSA),但對鏈球菌的作用不足。
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 28613693 
NIH
Impetigo 是由特定細菌引起的常見皮膚感染,容易透過接觸傳播。它通常呈現紅色斑塊,表面覆蓋黃色痂,可能伴隨搔癢或疼痛。此感染最常見於生活在溫暖潮濕地區的兒童。病變可出現水泡,也可無水泡。雖然常累及臉部,但亦可發生於任何皮膚破損處。診斷主要依靠臨床症狀與外觀。治療通常包括局部及口服抗生素,並進行症狀緩解。
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.