Impetigo - 膿皰瘡
下巴膿皰瘡一例。如果小孩沒有受傷史，但傷口樣病灶正在擴散，則應懷疑膿皰病。
與異位性皮膚炎不同，膿皰瘡需要抗生素治療，並且可能會因使用類固醇而惡化。
relevance score : -100.0%
ReferencesImpetigo 是 2 至 5 歲兒童中最常見的細菌性皮膚感染，主要有兩種類型：非大皰性（佔 70%）和大皰性（佔 30%）。非大皰性膿皰病通常由 Staphylococcus aureus 或 Streptococcus pyogenes 引起，表現為臉部和四肢上的蜂蜜色結痂，常見於皮膚破損、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引起，會形成大而鬆弛的水皰，常見於皮膚相互摩擦的部位。這兩種型態大多在兩至三週內自行痊癒，通常不留疤痕，併發症較少，最嚴重的是鏈球菌感染後的腎小球腎炎。 治療方面，局部使用抗生素（mupirocin、retapamulin、fusidic acid）是首選。若為大皰性膿皰或局部治療無效，則需口服抗生素。可選擇的口服藥物包括 amoxicillin/clavulanate、dicloxacillin、cephalexin、clindamycin、doxycycline、minocycline、trimethoprim/sulfamethoxazole 以及其他 macrolides，但青黴素類對金黃色葡萄球菌無效。外用消毒劑的效果不如抗生素，應避免使用。 其中，fusidic acid、mupirocin、retapamulin 能有效對抗對甲氧西林敏感的金黃色葡萄球菌和鏈球菌；clindamycin 對疑似 methicillin‑resistant S. aureus 感染有幫助；trimethoprim/sulfamethoxazole 可對抗耐甲氧西林的金黃色葡萄球菌，但對鏈球菌的作用有限。
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 是由某些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，可能伴有搔癢或疼痛。此感染最常見於生活在溫暖潮濕地區的兒童。臨床表現可為水泡，也可無水泡。雖然常累及臉部，但也可能出現在任何皮膚破損處。診斷主要依靠症狀與外觀。治療通常包括局部及口服抗生素，並進行症狀管理。
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，可在人與人之間傳播。於兒童中，常會傳染給兄弟姊妹。
治療通常使用抗生素乳膏，例如 Mupirocin(莫匹羅星) 或 Fusidic acid(夫西地酸)。若受累範圍較大，則可口服抗生素，如 Cefalexin(頭孢氨芐)。
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腎絲球腎炎。
○ 治療 - 非處方藥
* 由於膿皰瘡是一種傳染性疾病，因此不應使用類固醇藥膏。如果您無法區分膿皰瘡和濕疹，請使用非處方抗組織胺藥，避免使用類固醇藥膏。
#OTC antihistamine
* 請在患處塗抹非處方抗生素藥膏。
#Bacitracin
#Polysporin