This review found limited high- quality evidence to inform the treatment of impetigo .
BACKGROUND Impetigo is a common clinical problem seen in general practice .
Uncertainty exists as to the most effective treatment , or indeed if treatment is necessary .
AIM To determine the most effective treatment for impetigo in a systemically well patient .
Skin and plasma levels of acetylsalicylic acid: a comparison between topical aspirin/diethyl ether mixture and oral aspirin in acute herpes zoster and postherpetic neuralgia
Abstract Objective : The aim of this investigation was to eluci date whether the analgesic effect was due to the local aspirin or to the systemic drug . This was done by comparing skin and plasma levels of acetylsalicylic acid ( ASA ) and salicylic acid ( SA ) after topically administered ASA/diethyl ether ( ADE ) mixture in acute herpetic neuralgia ( AHN ) and postherpetic neuralgia ( PHN ) . The analgesia and the plasma and skin levels of ASA were also determined after oral administration of aspirin . Methods : Nineteen patients , 11 ( 57.9 % ) with AHN and ␣ 8 ( 42.1 % ) with PHN were given , on different days , a single 500-mg oral dose of ASA or a topical dose ( 750 mg ) of ( ADE ) daubed onto the painful skin . The analgesic effect was assessed by means of a visual analogue scale ( VAS ) . Overall pain relief was grade d as : excellent , good , fair , or poor . AHN as well as PHN patients had severe pain at baseline ( 6.83 and 5.93 ) . Levels of ASA and SA in plasma and in the stratum corneum after adhesive tape stripping of the treated area were determined by HPLC . Results : After ADE application , the analgesic effect was very rapid and VAS scores were lower than at baseline . Pain significantly decreased by 82.6 % after topical and 15.4 % after oral ASA . After ADE , 95 % of the patients had excellent or good pain relief , but after oral administration 79 % of the patients had a poor response . Pain relief was similar in the two subgroups after ADE . Skin concentrations of ASA , but not of SA , after ADE were about 80- to 100-fold those after oral administration . Levels of ASA and SA in plasma after oral administration were similar to those previously found , but after ADE were undetectable or very low . Patients with excellent pain relief showed a trend towards higher ASA skin concentrations . Conclusions : The analgesic effect can be obtained only after topical administration , because by this route the skin levels of ASA are much higher than after oral administration . The mechanism is exclusively local ; there are no active drugs in plasma after topical administration
This review found limited high- quality evidence to inform the treatment of impetigo .
BACKGROUND Impetigo is a common clinical problem seen in general practice .
Uncertainty exists as to the most effective treatment , or indeed if treatment is necessary .
AIM To determine the most effective treatment for impetigo in a systemically well patient .