Impetigo Bullosa

Impetigo Bullosa 

(also bullous impetigo, pemphigus neonatorum), a purulent skin inflammation afflicting newborn infants. Impetigo bullosa is caused by staphylococci or, less frequently, by streptococci or pneumococci. Contraction of the disease is promoted if the child is not bathed regularly and if its diaper is not changed often enough. Infection may be transmitted by adults suffering from pyoderma.

Bullae, or blisters, reaching 1.5–2.0 cm in diameter and filled with a cloudy serous-purulent fluid appear on the skin, principally on the neck, underarms, abdomen, and the inguinal region. The membrane of the blisters is very thin and ruptures easily, leaving round weeping but rapidly drying ulcerations. When the blisters burst, infected fluid is released, which then infects adjacent skin areas. The disease usually proceeds with elevated body temperature and severe general illness.

Impetigo bullosa is very contagious and can spread rapidly in maternity hospitals. Complications include sepsis and the formation of abscesses and phlegmons. With treatment, recovery follows in six to eight days. Treatment includes proper care of the infant’s skin, application of a 2-percent solution of silver nitrate to the ulcerations, and application of a solution of aniline dyes (methylene blue, brilliant green) to rashes. Antibiotics may also be required. Prevention includes the strict observance of sanitary measures and proper care of the infant’s skin. Persons with purulent skin disease should not be allowed to care for the child. Infants that have contracted impetigo bullosa must be kept in isolation in maternity hospitals.

N. D. MIKERINA