Impetigo — CCFP MCQ
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Correct answer: A — Impetigo
The diagnosis is impetigo. Honey-coloured crusted erosions are pathognomonic for non-bullous impetigo, the most common bacterial skin infection in children aged 2–5 years. The condition follows disruption of the skin barrier (here, scratching insect bites) and presents with characteristic golden/honey crusts on the face and extremities. At age 6, afebrile and well-appearing, this is typical of localised impetigo caused by Staphylococcus aureus and/or Streptococcus pyogenes. Herpes zoster produces painful vesicles in a dermatomal distribution and is rare at this age without immunosuppression. Erythema migrans is an annular expanding lesion associated with tick exposure and Lyme disease, without honey crusts. Tinea versicolor presents with hypopigmented or hyperpigmented macules of the trunk, not perioral erosions. Contact urticaria causes urticarial wheals, not crusted erosions.
Reference: College of Family Physicians of Canada. Management of impetigo and cellulitis. Can Fam Physician. 2017;63(8):615–621. https://www.cfp.ca/content/63/8/615