Clinical Application Questions

A 14-year-old girl presents at your afternoon clinic accompanied by her mother for evaluation of oozing blisters on the left upper thigh starting at the level of the gluteal crease. Onset was sudden with rapid progression over 3 days, and the lesions are both tender and pruritic. The mother is concerned about some sort of insect-bite reaction and about the rapid progression of the lesions. You suspect impetigo.

1. With what primary form of impetigo is this clinical course most consistent?

2. What provoking factors might account for this somewhat unusual anatomic location?

3. What are the primary lesions of bullous impetigo?

4. What are the secondary lesions of bullous impetigo?

5. What treatment should you start?

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