A 12-year-old boy presents with a crusted honey-brown lesion that affects his face

A 12-year-old boy presents with a crusted honey-brown lesion that affects his face. The rash began as red macules 3 days earlier. The best treatment is

A) Intramuscular ceftriaxone
B) Topical hydrocortisone cream
C) Oral ciprofloxacin
D) Topical mupirocin ointment
E) Oral acyclovir

Answer:
D. (Topical mupirocin ointment )

Discussion: Impetigo is caused by group A β-hemolytic streptococci or Staphylococcus aureus and typically affects young children. The lesions begin as erythematous papules that expand to form crusted patches with a honey-brown appearance. More severe cases may cause bullae to form. The infection occurs more commonly around the nose and mouth and in the intertriginous areas; there
are no constitutional symptoms.
Diagnosis is usually made on clinical presentation.
Treatment for mild infections includes 2% topical mupirocin ointment. More severe cases respond to dicloxacillin, cephalexin, or erythromycin. Impetigo is highly contagious.
Glomerulonephritis is a rare complication of impetigo that is caused by certain strains of Streptococcus.