Impetigo on Feet
Clinical Presentation
- Impetigo on feet presents in two main forms: Nonbullous impetigo (70% of cases) and Bullous impetigo (30% of cases), characterized by distinct clinical features 1, 3
- Ecthyma, a deeper ulcerated form of impetigo, may also occur on the feet, characterized by circular, erythematous ulcers with adherent crusts 3
Causative Organisms
- Nonbullous impetigo is caused by Staphylococcus aureus or Streptococcus pyogenes (Group A streptococci), or both 3
- Bullous impetigo is caused exclusively by toxin-producing strains of S. aureus 3
Risk Factors
- Minor trauma, abrasions, or insect bites that allow bacteria to enter the skin, and poor hygiene conditions are risk factors for foot impetigo 1, 2
- Pre-existing skin conditions such as athlete's foot (T. pedis) that create fissures between toes, and macerated or fissured interdigital toe spaces that can harbor streptococci are also risk factors 4
- Warm, humid environments that promote bacterial growth are additional risk factors 5, 6
Treatment Options
- Topical mupirocin 2% ointment applied three times daily for 5-7 days is a recommended treatment for limited lesions on feet 7, 3
- Oral antibiotics, such as dicloxacillin or cephalexin, are indicated for extensive foot lesions or when topical therapy is impractical 7, 3
Prevention Measures
- Good personal hygiene, thorough drying between toes after showers, and daily change of socks can help prevent foot impetigo 6, 8
- Treatment of underlying conditions like athlete's foot (T. pedis) and wearing rubber-soled flip-flops or sandals in communal showers can also help prevent foot impetigo 5, 6, 8