At 08:49 am sear69 Said :	+1
	you are welcome, dont know if it will help but it is all i can find at the moment

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	At 08:48 am sear69 Said :	+1
	TREATMENT Management options in impetigo include the following: 1. No treatment, waiting for natural resolution, hygienic measures 2. Topical antiseptics, such as saline, hexachlorophene, povidone-iodine and chlorhexidine. 3. Topical antibiotics, such as neomycin, bacitracin, polymyxin B, gentamycin, fusidic acid, mupirocin or topical steroid/antibiotic combination 4. Systemic antibiotics, such as penicillin, (flu)cloxacillin, amoxicillin/clavulanic acid, erythromycin, cephalexin The aims of treatment include resolving the soreness caused by lesions, the unsightly appearance of lesions on 'high expression areas' such as the face, and prevention of spread to other people. An ideal treatment should be effective, cheap, easy to use and accepted by patients. It should be free from side-effects, and should not contribute to bacterial resistance. For this reason antibiotics should not have an unnecessarily broad spectrum (Smeenk 1999; Espersen 1998) and the local antibiotic used should preferably not be one which may be needed for systemic use (Smeenk 1999; Carruthers 1988). Expecting a natural resolution could be acceptable if the natural history were known and benign. Impetigo is considered to be self limiting by many authors (Hay 1998; Resnick 2000). However, data on the true natural history of impetigo are absent. Reported cure rates of placebo creams vary from 8% to 42% at 7-10 days (Ruby 1973; Eells 1986). Topical cleansing used to be advised 30 years ago as an alternative for antibiotic treatment, but is said to be no more effective than placebo (Dagan 1992). Guidelines and treatment advice often do not mention this possibility as, frequently, the main concern is preventing the spread of the infection to other children. A choice has to be made between topical and systemic antibiotic treatment although sometimes dual therapy is employed. An advantage of the use of topical antibiotics is that the drug can be applied where it is needed, avoiding side effects like gastro-intestinal upsets. Also, compliance seems to be better (Britton 1990). The disadvantages of using topical antibiotics include the risks of developing bacterial resistance and of sensitization i.e. an allergic contact dermatitis to one of the constituents of the topical preparation (Smeenk 1999; Carruthers 1988). This is especially common with the older antibiotics such as gentamycin, bacitracin and neomycin (Smeenk 1999). Some preparations (e.g. tetracycline) can cause staining of skin and clothes. Staphylococcal resistance against penicillin and erythromycin is common (Dagan 1992). Bacterial resistance against the newer antibiotics, such as mupirocin ointment and fusidic acid ointment, is still limited (de Neeling 1998). Another advantage of the newer antibiotics is that mupirocin is never, and fusidic acid not often, used systemically.

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	At 08:47 am sear69 Said :	+1
	EPIDEMIOLOGY In the Netherlands, most patients with impetigo consult their general practitioner and approximately 1% of the cases are referred to a dermatologist (Bruijnzeels 1993). Although the incidence seems recently to have declined slightly it is still a common disease, particularly in young children. It is the third most common skin disorder in children after dermatitis/eczema and viral warts (Dagan 1993; Bruijnzeels 1993). In the Netherlands 2.2% of all children under 14 years consult their GP for impetigo each year (Bruijnzeels 1993). In British general practice it was 2.8% (age 0-4) and 1.6% in children age 5-15 (McCormick 1995). Peak incidence occurs between the ages of 2 and 6 years (Bruijnzeels 1993). In some tropical or developing countries, the incidence of pyoderma involving impetigo seems to be higher (Canizares 1993; Kristensen 1991).

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	At 08:47 am Animalfreak169 Said :	0
	thank you so much

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	At 08:47 am sear69 Said :	+1
	CAUSES Staphylococcus aureus is considered to be the main bacterium which causes non-bullous impetigo. However Streptococcus pyogenes or both S. pyogenes and S. aureus are sometimes isolated. In moderate climates, staphylococcal impetigo is more common, whereas in warmer and more humid climates, the streptococcal form predominates. The relative frequency of S. aureus infections has also changed with time (Dagan 1993). It was predominant in the 1940s and 1950s, then group A streptococci become more prevalent. Recently S. aureus has become more common again. Bullous impetigo is always caused by S. aureus. Secondary impetigo may occur as a complication of many dermatological conditions, notably eczema. The eruption appears clinically similar to non-bullous impetigo. Usually S. Aureus is involved. The underlying skin disease may improve with successful treatment of the impetigo and the converse may also be true. Complications of non-bullous impetigo are rare. Local and systemic spread of infection can occur which may result in cellulitis, lymphangitis or septicaemia. Non-infectious complications of S. pyogenes infection includes guttate psoriasis, scarlet fever and glomerulonephritis, an inflammation of the kidney that can lead to kidney failure. It is thought that most cases of glomerulonephritis result from streptococcal impetigo rather than streptococcal throat infection and this has always been an important reason for antibiotic treatment. The incidence of acute glomerulonephritis has declined rapidly over the last few decades. Baltimore stated that the risk of developing glomerulonephritis is not altered by treatment of impetigo (Baltimore 1985); however, certain subtypes of group A streptococci are associated with a much greater risk (Dillon 1979).

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	At 08:46 am sear69 Said :	+1
	BIOLOGY AND SYMPTOMS Impetigo or impetigo contagiosa is a contagious superficial bacterial skin infection, most frequently encountered in children. Impetigo is typically classified as either primary impetigo (i.e.. direct bacterial invasion of hitherto normal skin) or secondary or common impetigo, where the infection is secondary to some other underlying skin disease, such as scabies or eczema, which disrupts the skin barrier. Impetigo is also classified as bullous or non-bullous impetigo. Bullous impetigo simply means that the skin eruption is characterised by bullae (blisters). The term impetigo contagiosa is sometimes used to mean non-bullous impetigo, at other times it is used as a synonym for all impetigo. Non-bullous impetigo is the most common form of impetigo. The initial lesion is a very thin-walled vesicle, on previously normal skin, that rapidly ruptures. It then leaves a superficial erosion covered with yellowish-brown or honey-coloured crusts. The crusts eventually dry, separate and disappear leaving a red mark that heals without scarring. Typically the most frequently affected areas are the face and limbs. The lesions are sometimes sore. Usually, there are no systemic signs such as fever, malaise, or anorexia. However swelling of the lymph nodes draining the infected area of skin is also common. Spontaneous resolution can be expected within 2 to 3 weeks without treatment, in most cases, but prompt resolution occurs with adequate treatment. Diagnostic confusion can occur with a variety of skin disorders including shingles, cold sores, cutaneous fungal infections and eczema (Hay 1998; Resnick 2000). Bullous impetigo is characterised by larger bullae or blisters that rupture less readily and can persist for several days. Usually there are fewer lesions, and the trunk is affected more frequently than in non-bullous impetigo. Diagnostic confusion can occur with thermal burns, blistering disorders (e.g. bullous pemphigoid) and Stevens Johnson syndrome.

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	At 08:45 am Animalfreak169 Said :	0
	k

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	At 08:44 am sear69 Said :	+1
	oh well i do not have any other suggestions sorry

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	At 08:44 am Animalfreak169 Said :	0
	school blocks everything that has information you need, this school is gay~

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	At 08:44 am Animalfreak169 Said :	0
	tried and it doesnt show

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