KidStuff

Now Is The Season For Impetigo, The Rash That’s Not Just A Rash

By Paul M. Marz, M.D.
Summer approaches! At last, the buds are bursting and the flowers are out! And so are the children! (Please look out for them, they are outside running everywhere.) To children, summer means speed. We are still a ways from the “Dog Days” of heat and humidity, but winter is gone and done with.

Today we will talk about those red rashes that seem to not act like your normal rash. The medical term is Impetigo, and every school nurse knows to call you about it. This is a bit more than the run of the mill scratch and scrape, but seems to appear as a slow growing wet rash, and can appear almost anywhere. Spring is a common time for it due to the innumerable scrapes and scratches that our children collect in the course of a bright spring day.

Impetigo actually is an infection of the skin, and not in the same category as many of the childhood rashes. It ranks as one of the most frequently seen skin infections. Children are the record holders in the numbers of patients, but age is no protection from this minor infection. We usually see it on exposed skin, face, hands, arms, legs (when shorts are the norm) anything that can get scratched.

When first noticeable, it is just another red spot on a kid already covered with them. But instead of fading away, small thin-walled blisters or bubbles form on top of the skin. It does not take much to break the blister and you can notice a clear-to-cloudy thin fluid that quickly dries away into a crunchy honey crust over the area. This crusting is the hallmark of the diagnosis, when a nurse sees the crust, you get a phone call.

What’s going on is a combination bacterial infection of the Staph and Strep families (Staphylococci and Streptococci). Together they work as a team to undermine the uppermost layer of the skin. It is slow spreading, but spread it does. Once you have a lesion, it’s literally child’s play to spread this to other sites, hence the call from the nurse to limit exposure to classmates.

In recent months, we have read about flesh-eating staff infections and MERSA outbreaks, but good old common Impetigo has been around a lot longer and is most likely the cause of this infection that is marauding as a rash. A trip to your doctor for a topical medicine, and keeping the area clean and crust-free will quickly result in a cure that leaves normal skin behind. Severe or neglected cases may run deeper and require stronger medications, but your doctor can always help.

So, parents, check those wounds. The presence of that “Honey Crust” means, “Call your doctor.

(Dr. Marz, a board-certified pediatrician, is supervising physician for the Town of Barnstable school system. He practices with Bass River Pediatrics in South Yarmouth.)