Sains Malaysiana 42(1)(2013): 89–91

Peri-oral Bullous Impetigo: A Diagnostic Dilemma for Dentist

(Bullous Impetigo Peri-Oral: Satu Dilema Diagnostik untuk Pengamal Pergigian)

A.S.I. Zakaria* & S.N.M.P. Sockalingam

Department of Operative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia,

Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

Received:19 December 2011/Accepted: 18 May 2012

ABSTRACT

Bullous impetigo is a highly contagious skin infection commonly affecting children due to epidermolytic toxins of bacteria Staphylococcus sp. This presentation described a case of a 3 year-old Indian girl with bullous lesion around the peri-oral region. The lesion was initially thought to be of viral origin and was treated symptomatically. However, the lesion progressed without any resolution with more vesicles at distant sites. The patient was also having fever and refused any oral intake. At this point, a probable diagnosis of bacterial skin infection was considered and the patient was admitted. Intra-venous fluid was administered to rehydrate the patient and she was treated with topical antibiotic and antipyretic. The lesion resolved within 14 days without scarring. As dental practitioners, we should be aware of bacterial infection around the peri-oral region and consider it as part of a differential diagnosis so that an appropriate treatment can be given.

Keywords: Bacterial lesion; peri-oral bullae; skin infection

ABSTRAK

Bullous impetigo ialah infeksi kulit yang amat mudah berjangkit. Ia kerap berlaku dalam kalangan kanak-kanak dan terhasil akibat racun epidermolitik yang dihasilkan oleh bakteria Staphylococcus sp. Makalah ini membincangkan tentang lesi bula yang berlaku di kawasan peri-oral seorang kanak-kanak perempuan India berusia 3 tahun. Lesi ini pada mulanya dianggap sebagai jangkitan viral dan dirawat secara simptomatik. Akan tetapi, lesi ini tidak sembuh dan mula merebak ke bahagian badan yang lain. Pesakit pula mula mengalami demam dan enggan mengambil apa-apa makanan. Pada ketika itu, satu diagnosis pembeza infeksi kulit bakterial telah dipertimbangkan dan pesakit telah dimasukkan ke wad. Pesakit telah diberikan cecair secara intra-vena untuk proses rehidrasi. Pesakit juga dirawat dengan ubat demam dan antibiotik topikal. Lesi tersebut sembuh sepenuhnya tanpa sebarang parut dalam tempoh 14 hari. Sebagai pengamal pergigian, kita harus mempertimbangkan infeksi bakteria sebagai salah satu diagnosis pembezaan bagi lesi-lesi bula yang melibatkan kawasan peri-oral supaya rawatan yang sewajarnya dapat diberikan.

 Kata kunci: Bula peri-oral; infeksi kulit; lesi bakteria

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*Corresponding author; email: shuhud_zakaria@yahoo.com