Impetigo presents with which characteristic lesions and distribution?

• A. Vesicles, pustules with honey-colored crust; regional lymphadenopathy; Staph aureus MC; face
• B. Dry scaly patches on extensor surfaces
• C. Bullae in intertriginous areas
• D. Necrotic ulcers on legs

Answer: (C)

Impetigo can present in two forms, and recognizing the lesion type helps distinguish them. The bullous form features large, fragile blisters (bullae) that rupture easily and leave thin, yellow crusts. This pattern is driven by Staphylococcus aureus producing exfoliative toxins that damage the superficial epidermis. These lesions tend to appear in skin folds where moisture is trapped, so intertriginous areas are a common distribution site. This contrasts with the nonbullous form, which presents as vesicles and pustules that rupture to form honey-colored crusts most often on the face, around the mouth and nose, and sometimes with regional lymphadenopathy. So seeing bullae in intertriginous areas aligns with bullous impetigo as the characteristic presentation.