Does impetigo require systemic treatment? Treatment of impetigo

In medicine, impetigo is also called yellow water sore, which mainly appears on the face and limbs that are easily exposed. At first, erythema and rashes will appear, and soon they will turn into large yellow blisters, the size of soybeans, with yellow liquid inside. After the hemolytic mass ruptures, it will infect other parts of the body. It is necessary to receive treatment as soon as possible to prevent the infection from becoming more and more serious. Usually in terms of treatment, different principles such as systemic treatment and local treatment can be used to achieve the treatment effect.

1. General treatment of impetigo

1. Systemic treatment:

(1 ) Antibiotics or sulfonamides, such as penicillins and cephalosporins. For those who are allergic to penicillin, take erythromycin or spiramycin orally.

(2 ) For critically ill patients, it is best to perform pus culture plus drug sensitivity testing to select highly effective antibiotics.

2. Local treatment:

The principles of local treatment of impetigo should be sterilization, anti-inflammatory, antipruritic and drying. The methods are:

(1) If the blister wall has not broken, apply 10% sulfur calamine lotion externally.

(2) For patients with larger pustules, first puncture the blister wall with a sterilized needle. Then use a clean cotton ball to absorb the pus. If the pus has crusted over, use 0.5% neomycin solution, 0.1% ethacridine solution or 1:5000 potassium permanganate solution for external washing or wet compress, or 2% gentian violet solution for external application.

(3) For those with no exudation and scabby pustules, 5% aminomercuric oxide (white mercury) ointment, compound Xinmeijing ointment, erythromycin ointment, 5000u/g bacitracin ointment or Bactroban ointment can be applied externally.

2. Methods of treating impetigo in traditional Chinese medicine

1. Heat attack type:

Clinical manifestations: The disease mostly occurs in summer. The blisters are white and then become turbid and pus. The walls of the blisters are easily broken and eroded, and the patient feels itchy. After scratching, the blister fluid oozes out and new rashes appear. The tongue is red, with a thin yellow coating and a slippery and rapid pulse.

Treatment method: Clear away heat and relieve summer heat, remove toxins and eliminate dampness.

Prescription: Qingshu Decoction with modifications. 18 grams of Forsythia suspensa, 12 grams of pollen, 12 grams of red peony root, 12 grams of talc, 18 grams of honeysuckle, 12 grams of Alisma orientalis, 10 grams of loblolly leaf, 12 grams of dandelion, 12 grams of Viola yedoensis, 10 grams of peach kernel, 10 grams of safflower, and 6 grams of licorice.

Add or subtract: For patients with severe fever and thirst, add gypsum, Anemarrhena asphodeloides and Gardenia jasminoides. For constipation, add raw rhubarb (to be taken later). For abdominal distension and poor appetite, add Patchouli and Cymbidium.

2. Hot and toxic fumigation type:

Clinical manifestations: rash with erythema, pustules, erosions, accompanied by fever, thirst, irritability, constipation, yellow and red urine, red tongue, yellow and greasy tongue coating, and slippery and rapid pulse.

Treatment method : Clear away heat, detoxify, promote dampness and discharge pus.

Prescription : Wuwei Xiaodu Drink with modifications. 18 grams of dandelion, 18 grams of Viola yedoensis, 18 grams of honeysuckle, 12 grams of forsythia, 12 grams of wild chrysanthemum, 12 grams of purple-backed glabrous root, 12 grams of moutan bark, 24 grams of coix seed, 12 grams of pinellia, 12 grams of tangerine peel, and 12 grams of wild yam.

Add or subtract: For those with high fever and thirst, add gypsum, Anemarrhena asphodeloides, Ophiopogon japonicus, and Bambusa longifolia. If the sore surface is eroded and yellow fluid is flowing, add Atractylodes lancea, Gentiana scabra, and Patrinia chinensis. For constipation, add raw rhubarb.