Dermatology focuses on the health of the skin, hair, and nails. Learn about the diagnosis and treatment of acne, eczema, skin cancer, and cosmetic procedures.
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Diagnosis and evaluation of impetigo in dermatology are primarily based on clinical observation, as the condition has a characteristic appearance and predictable pattern of progression. In most cases, impetigo can be confidently identified through careful skin examination and review of symptoms without the need for extensive testing. Prompt and accurate diagnosis is important because impetigo is contagious and early treatment helps limit spread to other areas of the skin and to other individuals.
The evaluation process focuses on confirming that the lesions are consistent with a superficial bacterial infection, determining the type of impetigo present, and assessing the extent of skin involvement. This approach ensures appropriate treatment while avoiding unnecessary investigations.
Visual inspection is the cornerstone of diagnosis.
During examination, attention is given to the shape, color, and distribution of skin lesions. Impetigo lesions typically show clear signs of superficial infection.
Key features assessed include
• Honey-colored crusts or fragile blisters
• Moist or weeping skin beneath crusts
• Superficial erosions without deep tissue involvement
• Lesions clustered in exposed areas
These findings strongly support a diagnosis of impetigo.
Identifying the specific form guides management.
Evaluation distinguishes whether lesions are crusted and eroded, consistent with non-bullous impetigo, or whether intact fluid-filled blisters are present, suggesting bullous impetigo. This distinction is based entirely on appearance and does not usually require laboratory confirmation.
The pattern of involvement provides valuable information.
Assessment includes noting
• Number of lesions
• Body areas affected
• Signs of rapid spread
• Involvement of the face or scalp
More widespread involvement may influence treatment planning and follow-up.
Patient history supports diagnosis.
Evaluation may include questions about
• Recent skin injuries or insect bites
• Close contact with others who have similar lesions
• Attendance at group settings such as schools or childcare
• Personal or household hygiene practices
These factors help confirm the likelihood of impetigo and guide preventive advice.
Most cases do not require testing.
Laboratory tests such as skin swabs may be considered when
• Lesions do not respond to appropriate treatment
• Infection is unusually severe or recurrent
• The diagnosis is uncertain
Testing is used to clarify atypical cases rather than as a routine step.
Several conditions can resemble impetigo.
Evaluation aims to distinguish impetigo from
• Cold sores and other viral lesions
• Eczema with secondary infection
• Contact dermatitis
• Fungal skin infections
The presence of characteristic crusting and contagious behavior helps differentiate impetigo from these conditions.
Although uncommon, complications are considered.
Evaluation includes checking for
• Increasing redness or swelling around lesions
• Pain or warmth extending beyond the affected area
• Signs of deeper skin involvement
Early identification of complications supports timely management.
Accurate diagnosis allows impetigo to be treated promptly and appropriately, reducing discomfort, limiting spread, and promoting complete healing. Recognizing its typical features also helps reassure patients and caregivers, as impetigo is usually straightforward to manage when identified early.
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It is usually diagnosed through visual skin examination.
Most cases do not require laboratory testing.
Yes, but its crusting pattern is distinctive.
Yes, identifying bullous or non-bullous forms helps guide care.
If lesions are severe, recurrent, or do not improve with treatment.
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