1. Pyoderma

2. Pyoderma is usually caused by staphylococcal, streptococcal, or combined infection.
Pyoderma is a group of cocci infections in the skin, including impetigo, ecthyma, folliculitis, furuncle, carbuncle, erysipelas and cellulitis.
The quantity and the toxicity of the bacteria
The resistance of the body

3. Impetigo Occur most frequently on the exposed parts of the body
Contagious
Occur most frequently in childhood
Mostly during summer

4. Pathogen
Coagulasepositive Staphylocuccus aureus Group A beta-hemolytic streptococci
Group A beta-hemolytic streptococci and the phage type 71 and 80/81 S. aureus skin infections are sometimes followed by glomerulonephritis.
Enviroment: humid weather
Body: itching skin diseases

5. Clinical Type Impetigo vulgaris impetigo bullosa Impetigo neonatorum
Granuecthyma

6. Impetigo vulgaris Highly contagious Age: preschool age or school age
Season: summer and autumn
Locus: exposed parts of the body: perioral, paranasal and vulval regions

7. Impetigo vulgaris
Feature of the lesion: erythematous macula or papula, pustula, erosion, crusts
Subjective symptom: itching seriously
Course of disease: about one week
Systemic symptom: fever and lymphangitis may occur in serious disease, and more seriously septicaemia and acute glomerulonephritis may occur in disease.

8. Impetigo vulgaris

9. Impetigo bullosa Childhood, Summer
Impetigo often complicates miliaria, hidradenitis and insect bites
Bullae:pellucid to turbid exudate, like half bottle of water, after these lesions rupture, the exudate dries to form crusts and hyperpigmentation.
Impetigo circinata

11. Impetigo neonatorum
Phage type 71 coagulasepositive S. aureus or a related group 2 phage type
Rapidly evolving, highly contagious
pellucid to turbid exudate, Nikolsky’s sign (+)
dries to form loosely stratified golden yellow crusts
The disease evolves rapidly
Systemic symptom is serious: septicaemia,toxemia and die

12. Impetigo neonatorum

13. Granuecthyma
Deep and inflammatory vesicle or vesicopustule, ruptures to form ulcer and dark brown crusts
Causalgia, regional lymphonodi swell
Autoinoculation infection
The lesions tend to heal after 2-4 weeks, leaving scars or granulomatous lesions

14. Granuecthyma

15. Treatment
1. Clean the skin and cure the wound and itching skin diseases

16. Treatment 2. Systemic treatment:
sulfanilamide antibiotics or other antibiotics
Serious Impetigo neonatorum:
Topical therapy
High dose and sensitive antibiotics
General suppotive measures

17. Treatment 3. Topical therapy:
Principle: sterilize, diminish inflammation, astringe and desiccate
1% camphor、5% sulfurcalamine lotion, 0.5% novobiocin ointment
Impetigo neonatorum
Diers astringents and antiseptics
Granuecthyma
Remove the crusts, topical antibiotics ointment

18. Treatment
Isolation and disinfection

19. Thank you