Can a biopsy show mrsa? Mine showed Keratosis and Impetigo

[ClevelandErie]

Hi,

I am 30 years of age. I developed this irritating little growth on my skin. Yes, I did what I shouldn't have done and I picked at it. I went to a dermatologist who biopsied it.

The growth is benign. Keratosis. But then the pathologist also found impetigo.

I am not concerned about the benign growth, now I am concerned about the impetigo, I assume, secondary to scratching the growth.

1. How can a biopsy show impetigo on a tissue?
2. Can the pathologist confirm what kind of bacteria is causing the impetigo?

My concern is I have MRSA Impetigo. Is that possible? Would the pathologist be able to rule that out while looking at the specimen if he can already see the impetigo under the microscope?

Thanks.

[ruinedface]

Dear Dr. could you please tell me if a biopsy could only say "dermatitis' but really be imetago or worse? I have had this horrible HORRIBLE skin rash on my face for over 3 years and had 3 biopsies, two said "dermatitis", one said "connective tissue disease" but my bloodwork was neg for lupus. Only one culture was done (not recent) and it did not show bacteria. The lesions lOOK just like what I see online for impetago and the derm did just give me mupirocin topical so he must be considering it possible impetago.......it might, might be improving ???? on this the third day of mupirocin but if it is it is SLOW improvement. How long should it take to know? I have lots of trouble with oral antibiotics, including anaphalaxis so i was not given any at this time. I am worried the topical is not enough. Other topical antibiotics seemed to make it worse, as do steroid creams and other topicals. I am currently on oral pred pills because the facial swelling was out of control. You could not even see my nose bones and eyes were swollen nearly shut. Will the pred delay/prevent the healing? The lesions are oozing than ever now more following the application of the ointment, is this "poison' coming out? Does it mean it is working? These lesions bleed so easily and profusely that I do only warm water cotton balls to soften scabs before application of the ointment. The scabs seem to be much darker and harder now. Is this normal? When/how does this become classified as erthyma vs impetago? Mine seems severe and the lesions never completely heal, even if the surface does they seem to be lumpy and can "reactivate' anytime for no apparent reason. The worst are on the nose and cheeks but there are some on my forehead and chin and sometimes a few on my ear lobes. They do seem to run in lines and tend to match bilaterally. This has ruined my life. I look like a monster so I am a recluse. Now the derm here is passing me to the medical school although I have no idea how long it will take to get an appointment.

[Bhupinder Kaur, MD]

Hello,
impetigo can be diagnosed on biopsy but it is very hard to say whether it is by MRSA or some other bacteria. This can be confirmed only by bacterial culture of the discharge or skin specimen. So please get it done from a dermatologist. If impetigo is confirmed you need to start with topical as well as oral antibiotics.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.