Bullous impetigo

Bullous impetigo is a common contagious superficial skin infection mainly affecting children. It is due to Staphylococcus aureus, phage II, type 71. The bacterial toxins cause a split in the superficial epidermis.
The rash affects the face, trunk, flexures or extremities. It starts as small vesicles that rapidly enlarge into flaccid bullae; surrounding skin appears normal. These may rupture; leaving shiny erosions that soon dry up. The affected child usually has no systemic symptoms.
Treatment includes cleansing, removal of crusts and application of wet dressings. Localised impetigo may be treated with topical antiseptic (e.g., hydrogen peroxide cream or povidone iodine) or topical antibiotic (e.g., fusidic acid cream or mupirocin ointment). Extensive or recurrent infection may require oral flucloxacillin or erythromycin.