This article reviews in detail the pathogenesis, clinical characteristics and 
management of impetigo in children. Impetigo is the most common bacterial skin 
infection of children. Most cases of nonbullous impetigo and all cases of 
bullous impetigo are caused by Staphylococcus aureus. The remainder of cases of 
nonbullous impetigo are due to group A beta hemolytic streptococci (GABHS). 
GABHS colonize the skin directly by binding to sites on fibronectin that are 
exposed by trauma. In contrast, S. aureus colonizes the nasal epithelium first; 
from this reservoir, colonization of the skin occurs. Patients with recurrent 
impetigo should be evaluated for carriage of S. aureus. Superficial, localized 
impetigo may be treated successfully in more than 90% of cases with topical 
application of mupirocin ointment. Impetigo that is widespread or involves 
deeper tissues should be treated with a beta-lactamase-resistant oral 
antibiotic. The choice of antibiotics is affected by the local prevalence of 
resistance to erythromycin among strains of S. aureus, antibiotic cost and 
availability, and issues of compliance.