Infected Skin Impetigo Anatomy
To better understand impetigo, it helps to understand the anatomy of the skin.
The skin contains three main layers:
- The superficial layer that makes up the surface of the skin
- It is composed of skin cells and can be divided into 5 layers based on cell type.
- The top layer of the epidermis, the stratum corneum, is made of dead, flat skin cells that shed about every 2 weeks.
- The thickness of the epidermis varies, according to location: it is very thick over the soles of the feet, and very thin over the ears.
- Lies beneath the epidermis
- Also varies in thickness depending on the location of the skin. It is .3 mm on the eyelid and 3.0 mm on the back.
- The dermis is composed of 2 layers that contain a connective tissue called collagen
- The dermis contains blood vessels, nerves, sweat glands, and hair follicles.
- The number of structures in the dermis varies, according to location.
- The dermis under the arms contains more sweat glands and hair follicles than the dermis on the back.
- Subcutaneous layer:
- Mainly fat and connective tissue.
- Contains blood vessels and nerves.
- Epps RE. Impetigo in pediatrics. Cutis. 2004 May;73(5 Suppl):25-6. 
- George A, Rubin G. A systematic review and meta-analysis of treatments for impetigo. Br J Gen Pract. 2003 Jun;53(491):480-7. 
- Koning S, van Suijlekom-Smit LW, Nouwen JL, Verduin CM, Bernsen RM, Oranje AP, Thomas S, van der Wouden JC. Fusidic acid cream in the treatment of impetigo in general practice: double blind randomised placebo controlled trial. BMJ. 2002 Jan 26;324(7331):203-6. 
- Koning S, Verhagen AP, van Suijlekom-Smit LW, Morris A, Butler CC, van der Wouden JC. Interventions for impetigo. Cochrane Database Syst Rev. 2004;(2):CD003261.