Impetigo is a mild skin infection caused by Streptococcus and/or Staphylococcus aureus. Cellulitis is when the infection spreads into the deeper layers of the skin. Full length video with additional footage: https://youtu.be/OUluRyfjZfw

In this particular patient, impetigo was initially present involving the face, neck, legs, and arms. Video specifically focused on a cluster of lesions found on the back of the right thigh. It was treated with mupirocin and cephalexin, but the infection continued to get worse. Given the lack of improvement, cultures were obtained from the oozing sores which revealed a multi-drug resistant staph infection. By the time this information was finally obtained, cellulitis was present given the surrounding redness and induration. Appropriate culture-directed antibiotics was immediately started along with steroids to help with inflammation. Immediate improvement was seen within 24 hours.

As the infection resolved, the affected skin takes on a more bruised appearance. After oral antibiotics were completed, topical skin care alone was pursued until the skin completely healed. Ultimately, it took nearly a month for the skin to return back to normal.

Hopefully this 30 day time-lapse showing how the skin looks from from initial onset, to worsening, to finally resolution will help patients (and parents) understand visually the overall healing time course.

There is no single “right” way to treat such skin infections. But what was used successfully in the care of this particular patient (that is available over-the-counter, excluding prescriptions) included the following:

• Neosporin: https://amzn.to/3VT9tdH
• Aquaphor: https://amzn.to/3MX0W5f
• Betadine: https://amzn.to/3D2J9VM
• Clorox (for Bleach Baths): https://amzn.to/3f16iQn

Video on Bleach Baths currently in production.

Video created by Dr. Christopher Chang:
https://www.FauquierENT.net

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