
Q I heard there are several types of impetigo — how do they differ?
A It is divided into three types: non-bullous (honey-colored crusts, most common), bullous (large blisters plus thin crusts), and ecthyma (deeper ulcers). Severity and treatment intensity differ by type, so distinguishing them is important.
Detailed Answer
Impetigo is broadly classified into three forms. Non-bullous impetigo, accounting for more than 70% of cases, is the most common; it starts around the nose and mouth, with small blisters that rupture and leave honey-colored crusts. Bullous impetigo, caused by toxins from Staphylococcus aureus, splits the skin to form large blisters that, once ruptured, leave thin crusts; it tends to appear more on the trunk and limbs. Ecthyma is a more severe form in which the infection penetrates into the deeper skin layers, forming ulcers beneath the crust that may leave scars and requiring a longer course of antibiotic treatment.
Korean Medicine Clinic Perspective
At Dongjedang, we regard non-bullous and bullous impetigo as the early stage of damp-heat transforming into toxin (seup-yeol-hwa-dok), and the deeper, penetrating form like ecthyma as a stage where exuberant heat-toxin (yeol-dok) has damaged the qi and blood. For severe ulcerating ecthyma, it is safer to first receive Western antibiotic treatment, then add Korean medicine treatment after recovery to expel heat-toxin and reinforce the body's vital qi (jeong-gi).
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