We interrupt your summertime to present another Two Peds in a Pod® visual diagnosis learning session. Do you recognize this rash? Hint: it is mildly itchy and painful and can result from scratching bug bites or a skinned knee. Read on for the answer.
The rash on this child’s arm is impetigo. Impetigo is just a fancy name for a crusty skin infection on the surface of the skin. The infection is caused by the common germs that often lurk on our skin, Staphylococcus and Streptococcus. (You may recognize the germ Streptococcus from our sore throat post because it can also cause Strep throat). The germs wait for a break in our skin, from a tiny cut, pimple or a scrape, then invade the skin and spread. Impetigo is often seen next to the nose because the germs love to lurk in the nasal passages and kids often pick at the skin under the nose when it gets irritated from a cold virus.
Doctors tend to describe infections with appetizing food analogies (yes, we know- eew). In this case, impetigo is often described as having honey-colored-crusted lesions. The areas are tender and red, and often itchy. Kids often spread this infection on themselves when they scratch at the infection and then touch other areas of their skin.
Pediatricians treat impetigo with either a topical antibiotic or oral antibiotic for anywhere from 7 to 10 days. The choice of how to treat depends in part how much of the skin is affected and which body surfaces are involved. The infection is contagious until 24 hours after starting treatment.
Prevent this infection: Hand washing is a great way to prevent spread of impetigo. Washing all skin wounds well with soap and water is another way to prevent the emergence of this infection. See our prior post on wound care.
Ok, now back to the pool and barbeques for all our summertime readers. Just remember your bug spray and remind your children not to scratch and pick at their skin.
Naline Lai, MD and Julie Kardos, MD
©2013 Two Peds in a Pod®
A favorite pediatrician party game is to guess the age of a child by observing his skills and body habitus. Most people are stumped when it comes to differentiating between preschoolers. Here’s a hint: while three-year-olds look a bit pot-bellied because of weak abdominal muscles, four-year-olds look lankier because their muscles are stronger. 
We are so proud: Two Peds in a Pod® turns four years old today and our colleague, pediatrician Dr. Robert Sasson, wrote a sweet poem for us to share with our readers. Thank you, Dr. Bob!
The green crosses in the photo signify that the building is a medical marijuana dispensing site. As the TMZ tour bus director pointed out the crosses when my family was recently on vacation in Hollywood, I saw all the kids on the bus crane their heads to look at the building. As I watched the kids, I was reminded that it is summer time and summer brings late night parties for teens. For parents, it brings late nights of worry. “I’d know if my kid was high or drunk,” you say to yourself. Or would you? Here are some signs you can use to tell:
We are proud to 
Hot!
We are parents to three boys so needless to say, our house is always full of cuts, bruises or injuries of some sort. Band-Aids and “feel better” kisses are a regular part of our daily activity. And while my husband is a great “Doctor Dad” to all three boys, it is his every day involvement in my youngest son’s medical care that makes him a truly amazing father. 
Yesterday morning we were aghast to read medical misinformation in the print edition of our local newspaper. Aghast, because we were the pediatricians interviewed for the content of a summer time tips article. 
Two Peds in a Pod has reached over ONE MILLION visits!
