Young & Crusty

2. A child presents with a history of flaccid bullae and encased fluid progressing from clear yellow to turbid and darkish yellow. The pustules have ruptured, resulting in thin, light brown to golden yellow crusts and a collarette of scale at the periphery of the erosion. Itching is mild.

Diagnosis: Bullous impetigo most commonly affects neonates, hence the occasionally used (and inadvisably employed) name pemphigus neonatorum. Bullous impetigo appears to be less contagious than the nonbullous form and is usually sporadic in presentation. Typical areas of occurrence include the trunk and extremities, as well as intertriginous zones (eg, the diaper area, neck folds, and axillae).

For more information, see “Impetigo Update: New Challenges in the Era of Methicillin Resistance.” Cutis. 2010;85(2):65-70.