Pyoderma is a prevalent dermatological condition encompassing a range of primary and secondary skin infections. Primary pyodermas, which include impetigo, folliculitis, furuncle, carbuncle etc., pose a significant burden in dermatological practice. Secondary pyodermas comprise conditions like infected pemphigus, infected contact dermatitis, and infected scabies, often compounding the clinical complexity. The most frequently isolated organism in pyoderma is Staphylococcus aureus, which can be methicillin-sensitive (MSSA) or methicillin-resistant (MRSA). MRSA is a concerning healthcare-associated pathogen, and many isolates exhibit multidrug resistance. The pathophysiology of skin infections primarily involves disruptions in the skin's barrier, enabling pathogenic microbes to enter and triggering systemic reactions. Secondary infections occur when these pathogens invade diseased skin, and the specific pathogenesis varies based on the primary condition. Diagnosing bacterial pyodermas primarily relies on visual examination, occasionally supplemented by culture tests to confirm the presence of the causative organism. Treatment objectives encompass halting the progression of infection, alleviating discomfort, managing recurrent furunculosis, ensuring cost-effective interventions with minimal adverse effects, and swiftly eradicating severe infections. Antibiotics play a pivotal role in achieving these goals, serving as the primary treatment choice. Topical agents like mupirocin and erythromycin are often employed to cleanse affected lesions, eliminating the source of infection and reducing the potential for spread. In cases of extensive or severe infection, systemic antibiotic therapy becomes essential, administered either orally or via injection, to ensure effective eradication of the pathogen. This highlights the importance of early diagnosis, appropriate antibiotic choice, and comprehensive management to prevent complications and reduce the disease burden, antimicrobial resistance.


Pyoderma, Skin infection, Antibiotics, Antimicrobial resistance, Treatment goals, MRSA


  1. Gandhi S, Ojha AK, Ranjan KP, et al., Clinical and bacteriological aspects of pyoderma. N Am J Med Sci. 2012 Oct;4(10):492-5.
  2. Singh Th N, Singh Th N, Devi Kh S,et al., Bacteriological study of pyoderma in RIMS hospital. JMS - Journal of Medical Society 2005;19:109-12.
  3. Stulberg DL, Penrod MA, Blatny RA. Common bacterial skin infections. Am Fam Physician. 2002 Jul 01;66(1):119-24.
  4. May PJ, Tong SYC, Steer AC, Currie BJ,, Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review. Trop Med Int Health. 2019 Mar;24(3):280-293. 
  5. Leung TN, Hon KL, Leung AK. Group A Streptococcus disease in Hong Kong children: an overview. Hong Kong Med J. 2018 Dec;24(6):593-601.
  6. Clebak KT, Malone MA. Skin Infections. Prim Care. 2018 Sep;45(3):433-454.
  7. Chiller K, Selkin BA, Murakawa GJ. Skin microflora and bacterial infections of the skin. J Investig Dermatol Symp Proc. 2001 Dec;6(3):170-4. 
  8. Eley CD, Gan VN. Picture of the month. Folliculitis, furunculosis, and carbuncles. Arch PediatrAdolesc Med. 1997 Jun;151(6):625-6. 
  9. Vandersteen PR. Bacterial infections of the skin. Minn Med. 1974 Oct;57(10):838-43.
  10. Roberts S, Chambers S. Diagnosis and management of Staphylococcus aureus infections of the skin and soft tissue. Intern Med J. 2005 Dec;35(2):S97-105 
  11. Rerucha CM, Ewing JT, Oppenlander KE,, Acute Hand Infections. Am Fam Physician. 2019 Feb 15;99(4):228-236. 
  12. Sampson B, Lewis BKH. Paronychia Associated with Ledipasvir/Sofosbuvir for Hepatitis C Treatment. J Clin Aesthet Dermatol. 2019 Jan;12(1):35-37. 
  13. Cranendonk DR, Lavrijsen APM, Prins JM,, Cellulitis: current insights into pathophysiology and clinical management. Neth J Med. 2017 Nov;75(9):366-378.
  14. Thomas P. Habif: Clinical Dermatology E-Book. Elsevier Health Sciences, 6th edition 2015. 
  15. Bikowski J. Secondarily infected wounds and dermatoses: a diagnosis and treatment guide. J Emerg Med. 1999 Jan-Feb;17(1):197-206.
  16. Laurence L. Brunton, Bjorn Knollman et al.,: Goodman and Gilman's The Pharmacological Basis of Therapeutics. McGraw-Hill/Medical.13th edition 2017.
  17. Breyre A, Frazee BW. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. 2018 Nov;36(4):723-750. 
  18. Sahu JK, Mishra AK. Ozenoxacin: a novel drug discovery for the treatment of impetigo. Current Drug Discovery Technologies. 2019 Sep 1;16(3):259-64.
  19. Özçelik S, Kulaç ?, Yaz?c? M, Öcal E. Distribution of childhood skin diseases according to age and gender, a single institution experience. Turkish Archives of Pediatrics/Türk Pediatri Ar?ivi. 2018 Jun;53(2):105.
  20. Dipiro JT, Talbert RL, Yee GC, Pharmacotherapy: A Pathophysiology Approach, McGraw Hill, 10thedition 2017 
  21. Natsis NE, Cohen PR. Coagulase-Negative Staphylococcus Skin and Soft Tissue Infections. Am J Clin Dermatol. 2018 Oct;19(5):671-677.
  22. Brook I. The role of anaerobic bacteria in cutaneous and soft tissue abscesses and infected cysts. Anaerobe. 2007 Oct-Dec;13(5-6):171-7.
  23. Agak GW, Kao S, Ouyang K,, Phenotype and Antimicrobial Activity of Th17 Cells Induced by Propionibacterium acnes Strains Associated with Healthy and Acne Skin. J Invest Dermatol. 2018 Feb;138(2):316-324.
  24. Feingold DS, Hirschmann JV, Leyden JJ. Bacterial infections of the skin. J Am Acad Dermatol. 1989.Mar;20(3):469-75 
  25. Hedrick J. Acute bacterial skin infections in pediatric medicine: current issues in presentation and treatment. Paediatr Drugs. 2003;5(1):35-46. 
  26. Roberts S, Chambers S. Diagnosis and management of Staphylococcus aureus infections of the skin and soft tissue. Internal Medicine Journal. 2005 Dec 1;35:S97-105.
  27.  Pochi PE, Shalita AR, Strauss JS,,Report of the Consensus Conference on Acne Classification. Washington, D.C., March 24 and 25, 1990. J Am Acad Dermatol. 1991 Mar;24(3):495-500.
  28. Thomas L. Hale, Gerald T. Keuch et al., Medical Microbiology. University of Texas Medical Branch. 4th edition 1996.
  29. Loadsman MEN, Verheij TJM, van der Velden AW. Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data. Fam Pract. 2019 Jul 31;36(4):410-416.
  30. Smith DR, Dolk FC, Pouwels KB, Christie M, Robotham JV, Smieszek T. Defining the appropriateness and inappropriateness of antibiotic prescribing in primary care. Journal of Antimicrobial Chemotherapy. 2018 Feb 1;73(suppl_2):ii11-8.     
  31. Rush J, Dinulos JG. Childhood skin and soft tissue infections: new discoveries and guidelines regarding the management of bacterial soft tissue infections, molluscum contagiosum, and warts. CurrOpinPediatr. 2016 Apr;28(2):250-7 
  32. Lopez FA, Lartchenko S. Skin and soft tissue infections. Infectious Disease Clinics. 2006 Dec 1;20(4):759-72.
  33. Laureano AC, Schwartz RA, Cohen PJ. Facial bacterial infections: folliculitis. Clin Dermatol. 2014 Nov-Dec;32(6):711-4. 
  34. Nyirady J, Lucas C, Yusuf M,, The stability of tretinoin in tretinoin gel microsphere 0.1%. Cutis. 2002 Nov;70(5):295-8.
  35. Zaenglein AL, Pathy AL, Schlosser BJ, Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016 May;74(5):945-73.

Thayana Ramasamy
Corresponding author

Doctor of Pharmacy-Intern, Department of pharmacy practice, The Erode College of Pharmacy, Erode

Shavitha Jayaseelan

Doctor of Pharmacy-Intern, Department of pharmacy practice, The Erode College of Pharmacy, Erode

Gokulalakshmi Moorthy

Doctor of Pharmacy-Intern, Department of pharmacy practice, The Erode College of Pharmacy, Erode

Madhu Midha Muruganantham

Doctor of Pharmacy-Intern, Department of pharmacy practice, The Erode College of Pharmacy, Erode

Thayana Ramasamy*, Shavitha Jayaseelan, Gokulalakshmi Moorthy, Madhu Midha Muruganantham, The Skin Battle: Exploring The Depths Of Pyoderma Diagnosis, Treatment, And Management Strategies, Int. J. in Pharm. Sci., 2023, Vol 1, Issue 10, 210-218.

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