Overview
Impetiginized atopic dermatitis in adults is a complication of atopic dermatitis characterized by superimposed bacterial infection, typically Staphylococcus aureus, leading to localized or widespread skin lesions with crusting and purulent discharge 1.Diagnosis
Presence of atopic dermatitis history
Superficial or deep dermal abscesses with purulent discharge
Presence of S. aureus on Gram stain or culture 1
Clinical appearance of honey-crusted lesions (impetigo) 1Management
First-line treatments: Topical antibiotics (e.g., mupirocin) 1
Adjunctive treatments: Systemic antibiotics (e.g., dicloxacillin, cephalexin) for extensive disease 1
Dermatitis control: Topical corticosteroids or calcineurin inhibitors to manage underlying atopic dermatitis 1
Hygiene measures: Regular cleansing and drying of affected areas to prevent further infection 1Special Populations
Pregnancy: Limited specific guidance; systemic antibiotics should be used cautiously, favoring topical treatments where possible 1
Comorbidities: Management should consider concurrent skin conditions and potential drug interactions; close monitoring required 1Key Recommendations
Initiate treatment with topical mupirocin for localized impetiginized lesions (Evidence: Moderate) 1
For extensive or refractory cases, consider systemic antibiotics targeting S. aureus (Evidence: Moderate) 1
Control underlying atopic dermatitis with topical corticosteroids or calcineurin inhibitors to prevent recurrence (Evidence: Expert opinion) 1References
1 McRae C, Schroeder A, Anderson M, Turner L, Kole L. How Increasing Research Demands Threaten Equity in Dermatology Residency Selection and Strategies for Reform. Cutis 2025. link