Main Causes of Impetigo in Adults: Staph, Strep, Bullous and Non Bullous

While impetigo, the horrendously looking, vile and contagious skin infection, usually troubles little rug rats, it can certainly target grownups as well. It’s unexpected and atypical, but not utterly impossible.

Pro Tip: Impetigo is coded in the ICD 10 manual as L01.0 which is not billable. Further classifications are exclusive to children. Impetigo in adults would likely be coded L01.00 which signifies an overarching diagnosis of the unspecified sort, established by the World Health Organization (WHO) in November 2018.

Adults with children in the home are more susceptible to acquiring the infection.

What Causes Impetigo in Adults?

t’s precisely the same two pathogenic bacteria that make impetigo an issue in children are what causes impetigo in adults—staph and strep. Both of these harmlessly live and thrive everywhere on the epidermis, or more specifically, the stratum corneum.

Stratum Corneum: The most outward skin layer that’s made up of all the dead cells that have yet to shed and serves as a protective barrier against bacteria like staph and strep (keratinocytes). This layer also supports the containment of moisture. Gazing upon a mirror at your bare body, it’s both the epidermis and the stratum corneum that you’ll see staring back. Aging stratum corneum is responsible for the dry, flaky, scaly appearance in older people.

Infectious problems arise where the skin is broken apart (even the minutest graze) and the pathogens are able to sneak inside, gaining entry to the world beneath your sheathing.

Impetigo Variations

There are typically only two types of impetigo that garner notoriety, however, there is a third which should be talked about too. All three kinds of impetigo can either be impetigo staph (Staphylococcus aureus) or strep impetigo (Streptococcal aureus).

Non Bullous Impetigo

This kind of impetigo is the most seen in pediatric patients. Non bullous impetigo was originally referred to as impetigo contagiosa, but that moniker has since become antiquated.

Starting out as a singular reddish papule that rapidly transforms into a vacuole or vesicle. After the vesicles pop, the oozing innards become encrusted, and the color changes from red to honey and pruritus ensues.

Bullous Impetigo

Bullous impetigo is classically categorized as presenting with blisters in formation. These raised, pustular sacs have defined edges and hyperemia and erythema don’t usually develop around the lumps. They enlarge fast and are prone to breakage, as the covering is thin and its integrity is easily compromised. When explosion occurs, a yellowy liquid oozes out, subsequently crusting or scabbing over.

Ecthyma Impetigo

Of the impetigo categories, ecthyma is the only one that leaves everlasting scars in its wake. The ulcerative pyoderma is considered the “deepest” version of impetigo. Because of its depth in the integumentary system and dermis, this penetrative and invasive impetigo is very painful for the patient.

Identifying Impetigo

Symptoms and signs of impetigo in adults and onset can be broken down into two main categories—blistering and non.

With blistering impetigo, itty bitty blisters abruptly appear on miscellaneous parts of the body—be them facial macules (most common), or on the torso or extremities. These pustules are often without pain, though general dread, feelings of unwellness, and aches may coincide with the infection’s manifestation. These blisters will be less than an inch in total diameter and are delicate, spontaneously bursting in a moment’s notice.

Non-blistering impetigo, on the other hand, presents more like zits instead of papules. These smallish pimples are crimson red like a Macintosh apple—but not for long. Soon after they reveal themselves, they too will burst and dribble with an amber fluid that quickly hardens and crusts over. This version is very apparent on the face and on regions of the skin where there’s been recent trauma. Most grown sufferers of non-blistering impetigo report overwhelming itchiness and weakness. The lymph nodes sometimes protrude as they become swollen.

Impetigo can be mixed up with many other skin conditions, so seeing a healthcare professional is suggested to ensure a legitimate verdict.

Irrespective of the prognosis, avoid neurotic excoriations as this can promote the rapid spreading of bacteria and infectious pathogens. Seek a medical opinion ASAP to begin treatment, and once an antibiotic therapy has been instituted, you can count on the pruritic sensations to cease.

If left untreated, most instances of impetigo will subside without consequence or sequelae. However, due to impetigo’s incredibly infectious nature, promptly starting a course of antibiotics (topicals or orals) is the safest bet.

Indeed, certain strains of the affliction are unresponsive to antibiotic treatments, such as MRSA. Mild cases of this can be treated in an outpatient setting, but it should be attended to with haste.

Effective Prevention Methods

If your child brings back an impetigo rash from daycare, impetigo in adults can still be prevented by maintaining a few practices associated with a hygienic lifestyle.

  • Thoroughly clean and completely cover any open skin lacerations on all household members.
  • Don’t lend or divvy up any linen or clothes amongst eachother.
  • Wash the infected child’s clothing in hot water and strong detergent daily.
  • When applying topical ointments to their impetigo ulcers, always wear disposable latex (or equivalent) gloves.
  • Make perfectly sure your kid isn’t picking at or scratching at their impetigo sores—this fosters infection spreading.

 

 

Article References:

  1. https://www.uptodate.com/contents/impetigo
  2. https://emedicine.medscape.com/article/965254-overview
  3. https://www.ncbi.nlm.nih.gov/pubmed/15559440
  4. https://www.health.ny.gov/diseases/communicable/athletic_skin_infections/bacterial.htm
  5. https://www.skinsight.com/skin-conditions/adult/impetigo
  6. https://icd.codes/icd10cm/L010
  7. https://www.aafp.org/afp/2007/0315/p859.html

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