Types of streptococcal impetigo: bullous, slit, tournamentol, annular

August 12, 2017 15:30 | Impetigo

Streptococcal impetigo is characterized by the appearance of pustules, blisters on the skin, transmitted during a contact with a sick person.The name comes from the Latin word impetigo, which means "scab".

Types of streptococcal impetigo

The forms of the disease are classified according to external manifestations. Common to all varieties, with the exception of dry impetigo, is the formation of a flirting surrounded by a strip of inflamed skin.

The phlyctena( phlyctaena - vesicle, blister) hardly rises above the surface of the skin.The diameter fliken reaches 0.5-1 cm, the bubble is filled with a transparent exudate containing leukocytes, bacteria.They are infected with streptococci when injuring the skin - wounds, cuts, scratches.

more details about the different types of streptococcal impetigo, and some similar diseases specialist will tell in the video below:


Ill mostly adults.With bullous impetigo, bullae are formed - convex bubbles arising in the lesion, the site of infection,

with crusts more dense than other types of impetigo.

Bullas reach a diameter of 2 cm, are localized more often on the back of the hands, sometimes appear on the skin of the feet, shins.Exudate filling flikenu contains pus, because of which at the dissection on the skin there is ulceration, which does not heal for a long time, requiring the use of antibiotics.

bullous impetigo( photo)

Bullous impetigo children


to slit impetigo characterized by localization at the site of skin folds - in the corners of the lips, nose wings, the outer corner of the eye.The corners of the mouth are most injured during dental surgery, the wings of the nose are macerated in the rhinitis, the corners of the eyes - when hygiene is disturbed.

Most often, pustules appear in the corners of the mouth, which is accompanied by drooling, long-lasting non-healing sores or "zaedami."Streptococcal congestion is local in nature, does not spread to other areas of the skin, is not accompanied by itching, tenderness arises from cracks in the corners of the mouth.

Next, we'll tell you about post-erosive syphilliform impetigo.

Posterozivnoe sifilopodobnoe

phlyctenas distributed over a vast area of ​​the skin, are marked on the buttocks, external genitals, the rear surface of the femur.This type of streptococcal infection is more common in infants.It differs from other types of streptococcal impetigo by the appearance of a bluish-blue color leaving spots of erosion after opening.

Next, let's talk about annular impetigo.


Impetigo of nail rollers or tournamentol is more common in adults.Flicken occurs on the spot burr, the injured area of ​​the skin, the wound, when it receives streptococci.Contribute to the penetration of infection in the tissues surrounding the nail, combing the itchy skin.

A bubble appears around the nail roller, surrounds it in the form of a ring.The content changes rapidly from serous to serous-purulent.Inflammation causes discomfort with constant itching, pain, fever, deterioration of well-being, swelling of the affected phalanx, impaired ability to work.

The nail roller swells, becomes inflamed, the cuticle disappears.Sometimes inflammation causes rejection of the nail plate.

Tournament( photo)


The disease begins with the appearance of several flat large flies.Vesicles rapidly increase in size due to expansion in diameter.On the periphery, new fictionens are being eliminated, which in turn are screened out.

As a result, circular, garlandlike foci of lesions are formed on the skin.The center of the fiction disappears, forming a brown crust on the surface.

Impetigo of the mucous membranes

Blits almost flattened arise in the oral cavity on the mucous tongue, the inner side of the cheeks, gums, hard palate, affects the mucous lining, the cornea.Impetigo of the mucous membranes usually does not arise as an independent disease, often accompanies streptococcal lesions of the skin.

Streptococcal intertrigo

This type of impetigo is quite common in adults who do not observe hygiene and who suffer from excess weight. Flickety are located in groups, prefer large skin folds - glutes, under the mammary glands, armpits, in the folds of the groin, abdomen.

Merging, the phlycenes form damp erosive areas with a scalloped edge.The stain of erosion gradually increases in size, gives screenings, and a painful fissure is formed at the center, which is difficult to treat.

Simple lichen

Streptococcal dry impetigo or simple lichen occurs without the formation of a flicten.Symptoms of the disease manifest themselves in the form of bright spots of rounded shape, appearing on the skin.Usually this disease ill children.

Light spots appear on the face, limbs, trunk.

Differences and similarities between them

Streptokokkovogo-impetigo-1 With streptococcal impetigo, there are general symptoms characteristic of all types of diseases, as well as differences distinguishing them from each other.General deterioration of well-being with streptococcal superficial skin infection is rarely seen, only when a large area is affected or in children.

General symptoms:

  • increased regional lymph nodes located in the area of ​​inflammation;
  • temperature increase;
  • lack of appetite;
  • signs of intoxication - lethargy, weakness.

Differences between types of impetigo are noted in external manifestations.

  • So, the syphil-like post-erosive impetigo must be distinguished from the syphilitic pemphigus caused by pale treponema.
  • It is also necessary to distinguish streptococcal infection from microbial eczema, which is accompanied by pronounced reddening of the skin, multiple screenings of small bubbles along the periphery.


A common form of streptococcal impetigo is a simple form, usually found in children under 12 years of age.The disease develops in stages.From the first fliken, the appearance of which remains, as a rule, unnoticed, until the appearance of severe symptoms of the disease takes 5-7 days.

This is the time required for the maturation of a single bubble on average, after which:

  1. ripens fliten;
  2. fluid with streptococci enters the skin, spreading to the skin, a yellowish scab remains on the site of the fiction;
  3. , after the fall of the scab, redness remains, which occurs after a few days.

Bullous impetigo is difficult.Unlike other types of this disease, the bullous form of inflammation is accompanied by edema, deterioration of the general condition, a change in the blood formula.


Diagnostic examination reveals the nature of the disease, determine whether it originated primarily as a result of the penetration of streptococci, or again - due to scratching with itching dermatoses.

In primary impetigo, the disease is differentiated from fungal infection, syphilitic damage by laboratory testing.Streptococcal impetigo is distinguished:

  • with herpes;
  • is a pemphigus of newborns;
  • by staphylococcus, vulgar impetigo;
  • with impetigo syphilis;
  • with eczema.


  • With streptococcal impetigo, blisters are not associated with the hair follicle, which distinguishes this type of disease from staphylococcal impetigo.There are no pustules perforated in the center of the hair.
  • The color of the crusts also differs.When staphylococcal infection, the scabs are dirty-green, brownish, unlike yellowish scabs when infected with streptococci.
  • The color of crusts can be distinguished from streptococcal infection from vulgar impetigo, in which the crusts are crumbly, yellowish-greenish in color.

In terms of appearance, one can distinguish streptococcal impetigo:

  • from the impetigo syphilis - there are no freckles filled with a clear liquid, but large red papules;
  • from pemphigus of newborns - flicken appear, but they have an unusually large size, reach 2 cm in diameter, are localized on the trunk, and not on the face and extremities, as with streptococcal infection.

Differences in the treatment of impetigo nail rollers, tournamentol, bullous, slit and other types of streptococcal impetigo, including tests, will be discussed below.


Streptococcal impetigo species Antibiotics are used for disseminated impetigo, bullous form of the disease, prescribe:

  • penicillin intramuscularly;
  • sulfonamides;
  • vitamins.

Locally used:

  • ointments with antibiotic - biomycin, colimycin, polymyxin;
  • solutions of antiseptic - green, a solution of pioktanin;
  • mercurial ointment, boron-dyagtern ointment.


  • The bullous form has its own particular treatment.Bulls filled with pus are opened.
  • A protracted character is a sliced ​​impetigo.Frequent injury to the corners of the mouth with dental prosthesis in the elderly, the habit of licking the lips in children does not allow the opened pustule to heal, supports the focus of inflammation.
  • In the treatment of pemphigus of newborns, a synthomycin emulsion, ichthyol paste, ointment based on mercury is used.

Vitamin A, B, C are prescribed to strengthen immunity. The lack of vitamins of group B is considered one of the reasons for frequent streptococcal jaeda, the appearance of painful cracks in the corners of the mouth.

The treatment of streptococcal impetigo in children will be described by Elena Malysheva in this video:


Possible complications of any impetigo:

  • lymphadenitis;
  • boils;
  • kidney disease glomerulonephritis.


For all types of streptococcal impetigo, the following is the prophylaxis:

  • patient isolation;
  • hygiene compliance;
  • timely treatment of skin lesions with disinfectants;
  • treatment for a dermatologist or infectionist when symptoms of infection occur.


The prognosis for all types of streptococcal impetigo is favorable.

More information about bullous dermatitis can be found in the video below: