Impetigo? Local GP unable to diagnose.

I am 19 years of age, and going on a cruise later this year. When i was younger (around 11-15) and went on holiday, i would usually get a yellow crust which always appeared around my mouth and lips, nowhere else, and crusted up so badly that it would sort of close my mouth up, so i could not eat as opening it would be too painfull.

I discovered that i would only get it if i came into direct contact with the sea, if i would swim in it i would usually get it if i didnt shower immediatly afterward.

   It never bled, just had a yellow crust. Local GP has said that it is possibly non-bullous impetigo, and another GP said it could be infected eczema. I have looked at images on various websites for impetigo but none of them really seem to match mine when i was younger.

My skin complaint was as if i had smeared shavin foam around my mouth, (except it would be a yellow crustyness) and therefore what i am describing, is an even layout of this yellow crust, no bumps or sores etc.
I always seemed to get this crust only if i had been in contact with the sea, aka salt water.

So my question to you is, do you think this may be anything other than Impetigo? And is it likely that i could contract it on the cruise ship without going into the sea water? As in, is it possible the salt watery air could bring back up this skin complaint? The last time i got it was from what i recall, last year on holiday in Cornwall, again i was near the coast and i had come in contact with the sea.

Thankyou for all answers and speculations.

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks more like eczema rather than impetigo. Some forms of eczema can be triggered by substances that come in contact with the skin and in your case seawater can be a trigger. It causes dry, reddened skin that itches or burns and which is flaky in nature. My sincere advice would be to get it evaluated from a dermatologist.

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.