Rx for Readers: Impetuous impetigo

Impetigo is a superficial infection on – but not in – the skin that is caused by Staphylococcus bacteria.

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April 9, 2010 23:43
3 minute read.
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My youngest child, who is a year old, was recently diagnosed with both chicken pox and impetigo. She had a total of six pox, two of which turned into huge boils. How can one avoid this?

    – A.D., Jerusalem

Veteran Jerusalem dermatologist Dr. Julian Schamroth comments:

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Chicken pox is a common illness caused by the varicella zoster virus and usually occurs in childhood. The usual symptoms are fever, malaise, muscle pains and loss of appetite, followed by a rash, which initially appears as small reddish papules and may develop into small blisters and then scabs. The condition is contagious until the scabs fall off. Sometimes, due to scratching, the lesions may develop a secondary bacterial infection, which may appear as boils or oozing crusts. In adults, the illness is more severe, and secondary complications such as hepatitis, pneumonia or encephalitis may occur. There is a protective vaccine against chicken pox that is available, but it is not yet included in the basket of health services.

Treatment is essentially for symptoms – stop the itching with topical calamine lotion, prevent damage from scratching by cutting the fingernails short and treat any associated fever and any infection due to the pox with topical or oral antibiotics. In adults, oral anti-viral therapy is usually administered.

Impetigo is a superficial infection on – but not in – the skin that is caused by Staphylococcus bacteria, which can spread through the air, on contaminated surfaces and from person to person. Many healthy people carry the bacteria on their skin but are not affected by it. But when the skin is punctured or broken, staph bacteria may enter and cause infections such as impetigo. The infection appears as oozing lesions with honey-colored crusts. Impetigo can affect skin anywhere on the body but commonly occurs around the nose and mouth. It usually appears in preschoolers and school-age kids, especially during the summer months. I often see it in kids with eczema who get it from scratching the skin.

Kids can carry staph bacteria from one area of their body to another – or pass it to other people – via dirty hands or fingernails. To avoid infection with the bacteria and the transmission of impetigo once someone in your family has it, cut fingernails short and keep fingers clean and observe the rules of general hygiene, such as regular washing of hands with soap and bathing. Impetigo is treated with topical (skin) antibiotic ointments or sometimes oral antibiotics.

Some weeks ago, you wrote in Rx for Readers about taking magnesium to relieve memory problems. You mentioned that spinach is a good source of magnesium. I am an 81-year-old man, and I eat a vegetable salad every day. Should I add uncooked spinach to the salad? I heard or read somewhere that one should not eat raw spinach, but I don’t remember why.

    – G.S., via e-mail

Olga Raz, chief clinical dietitian at Tel Aviv Sourasky Medical Center, replies:



Daily consumption of 300 milligrams of magnesium is recommended for adults. There is no problem eating fresh spinach if it is well washed. If you want it cooked or steamed, make sure that you don’t throw away the cooking water, as all the minerals wash out into it. Minerals are not destroyed by heat. You can also eat frozen spinach, but also consume the water in which you heat it. You can eat both frozen or cooked as well as fresh spinach.

However, there is really not enough magnesium in spinach to have a major effect on memory. It is best to take magnesium pills, but they must be water soluble – not hard pills you swallow – or in the form of a powder added to water or food. Do not buy magnesium in combination with other minerals, but magnesium alone. And it is best to take magnesium supplements between meals or before going to bed.

Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and residence.

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