In the following clinical condition honey-like crusts are seen around the mouth in a baby. Identify the following skin disease?

Appeared in: NORCET -3 (Shift-2)

Explanation

The defining feature of non-bullous impetigo is the presence of honey-colored or amber-colored crusts, which form after small vesicles or pustules rupture.
This condition is a superficial bacterial skin infection, most commonly caused by Staphylococcus aureus or Group A Streptococcus.
As seen in the image and described in the stem, the lesions are typically located around the nose and mouth, which is a common site for impetigo in children.
The infection is highly contagious and spreads easily through direct contact.

Option A: Scabies is a parasitic infestation caused by a mite. Its hallmark signs are intense itching (especially at night) and linear burrows, not honey-colored crusts.
Option C: Atopic dermatitis (eczema) is a chronic inflammatory condition characterized by dry, itchy, and erythematous skin patches. While secondary bacterial infection can cause crusting, the primary lesion is not a honey-colored crust.
Option D: Food poisoning is a gastrointestinal illness resulting from the ingestion of contaminated food. Its symptoms include nausea, vomiting, and diarrhea, and it does not cause primary skin lesions like crusts.

Clinical Relevance

Nursing practice connection: Knowing Identification of common pediatric skin infections based on classic clinical signs helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing impetigo is crucial for nurses to initiate contact precautions and prevent its spread in pediatric and community settings.
Patient education on hygiene, medication adherence (topical or oral antibiotics), and preventing transmission is a key nursing responsibility.
Nurses must monitor for complications like cellulitis (spreading redness, warmth, swelling) or post-streptococcal glomerulonephritis (hematuria, edema), although the latter is rare.

How to Approach the Question

First, analyze the question stem for key descriptive words. The phrase 'honey-like crusts' is the most critical piece of information.
Next, examine the image provided to see if it corroborates the description. The visual of golden-yellow crusts around the mouth confirms the text.
This type of question tests your knowledge of pathognomonic signs—classic symptoms that are highly specific to a single disease.
Evaluate each option against the key sign. 'Honey-like crusts' is the textbook definition of non-bullous impetigo.
Eliminate the other options based on their distinct characteristics: Scabies (burrows, intense itch), Atopic Dermatitis (dry, eczematous patches), and Food Poisoning (GI symptoms).

Concept Tested & Keywords

Concept Tested: Identification of common pediatric skin infections based on classic clinical signs.
Stem keywords: honey-like crusts, around the mouth, baby, skin disease
Lead-in keywords: Identify
Clinical cues: The phrase 'honey-like crusts' is a pathognomonic (classic) sign strongly indicating non-bullous impetigo.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1960-1962

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1711-1713

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 3 (pp 477-702 of 713) p. 15-17

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