Grind lichen (Impetigo contagiosa)

A common bark lichen (also known as impetigo contagiosa) is a bacterial skin infection that is mostly caused by staphylococci, more rarely by streptococci. The highly contagious disease is transmitted by smear infection. Even in many healthy people, these germs can be detected in the nasopharynx without them suffering from a grind.

As the pathogens can only penetrate the skin through small wounds or as a result of a lowered immune defence, children with neurodermatitis, chicken pox or scabies in particular have an increased risk of contracting the disease.

Young children and schoolchildren are frequently affected - cases of the disease usually occur more frequently in kindergartens and schools. However, people of other age groups can also fall ill with a grind.

The areas of skin usually affected by a grind lichen are the face and the extremities.

Grind lichen is primarily caused by staphylococci (mainly Staphylococcus aureus), sometimes also by streptococci. The germs are transmitted either by direct contact with the source of infection or indirectly as a smear infection via contaminated hands or everyday objects such as towels and glasses.

The incubation period (time from infection to the first appearance of symptoms) is in most cases between two and ten days. Only when the open, purulent skin areas have healed is there no longer any risk of transmitting the bacteria to other people.

Grind lichen manifests itself in the form of fluid- or pus-filled blisters, which mainly appear on skin areas around the mouth and nose as well as on the hands. When these blisters burst, the typical honey-yellow crusts with a red border appear. A distinction is made between a small-blistered and a rarer large-blistered type of grind lichen, whereby the small blisters burst more easily due to a thinner wall layer. A severe occurrence of the large blister variant may additionally be accompanied by mild fever and swollen lymph nodes. As the contents of the blisters contain high concentrations of pathogens, it is possible for the germs to be transmitted to other areas of the skin or to humans through contact with them.

A diagnosis of the Grindflechte is mostly made on the basis of the typical appearance. Laboratory diagnostics can also detect the pathogens directly in the vesicular fluid or in swabs from the nasopharynx and indirectly via antibodies in the blood.

In order to test the pathogens for possible antibiotic resistance, a bacterial culture of the sample can be prepared.

In most cases, the treatment consists of applying an antiseptic (agent against wound infections) or an antibiotic to the affected skin areas. If the lichen is very severe, oral antibiotics may also be necessary for healing.

To ensure better healing and to prevent the spread of the disease, it is especially important to maintain good hygiene. The infected skin areas should not be touched; hands must be washed thoroughly with soap after each contact with a sick child. Children should also make sure that their fingernails are cut short, as this reduces the risk of scratching open the sores and spreading the germs.

Grind lichen usually heals quite well and without consequences with timely and consistent treatment. During the disease, swelling of the lymph nodes is possible and in rare cases the pathogens can spread to deeper layers of the skin and thus cause an inflammation of the nail bed. A very rare complication is inflammation of the kidneys (glomerulonephritis) caused by streptococci - in order to be able to detect this at an early stage, the urine should be examined at the beginning of the disease and after about six weeks.

If, despite therapy, the grind lichen continues to spread or does not heal after three days, the doctor should be consulted again.

To reduce the risk of infection, care must be taken to maintain good hygiene when dealing with sick people. After contact, hands should be thoroughly cleaned with soap - the bacteria in possibly contaminated textiles, such as towels or bed linen, are reliably killed in the washing machine at 60°C.

As the grind is no longer contagious until all crusts have fallen off, children should not go back to school or kindergarten until this point.