Non-bullous impetigo

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1B72.1

Small-bulb impetigo, non-bullous impetigo.

The non-bullous form is more common than the bullous variant. Usually staphylococci are the trigger, sometimes there is a mixed infection or colonisation with group A streptococci.

Macular erythematous lesions with severe exudation and honey-yellow crusts are seen mainly on the face, especially under the nose, but also in other locations (neck, trunk, hands, etc.). In addition, tense, water-clear vesicles are visible. Often, no primary florescences can be identified. In the course of the disease, healing occurs without scarring.


  • Clinical presentation
  • Bacterial smear
  • ASL titer, ASO titer
  • Urinanalysis (to rule out glomerulonephritis), follow-up after 2-4 weeks recommended
  • In adults, HIV infection should be excluded

Mostly on the face, especially under the nose, but also in other locations (neck, trunk, hands, etc.).

Spongiosis and subtle inflammatory reaction of the deeper epithelium. Subcorneal pustule formation (bacteria, fibrin and neutrophil leukocytes).

  • Purulent conjunctivitis
  • Otitis media
  • Postinectic glomerulonephritis
  • Rheumatic fever

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  2.  Kikuta H, Shibata M, Nakata S, Yamanaka T, Sakata H, Akizawa K et al. Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmec Type II in Children with Impetigo in Japan. Int J Pediatr 2011;2011:143872. 
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  6.  Miller M. Cost-effectiveness of erythromycin versus mupirocin for the treatment of impetigo in children. Annals of Emergency Medicine 1993;22:143. 
  7.  Nishifuji K , Amagai M. [Loss of adhesive function of desmogleins in bullous diseases: pemphigus and impetigo]. Tanpakushitsu Kakusan Koso 2006;51:796-802. 
  8.  Strickland DS. Review: topical mupirocin or fusidic acid may be more effective than oral antibiotics for limited non-bullous impetigo. Evid Based Nurs 2005;8:11