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One ubiquitous characteristic of medical mission work is regularly seeing advanced cases of conditions that are rarely allowed to get so advanced in less disenfranchised populations. This little boy’s rampant head impetigo required aggressive soap and water, lancing of abscessed collections of pus, and systemic antibiotics.
It helps to know that the moms in this indigenous population also strongly believe that a chilled head means fever, and in 80+ degree weather the small kids are often wearing knit caps that collect sweat and heat. Older kids hide their head impetigo under a baseball cap.
This child was also empirically treated for scabies, since scabies is endemic in this population and frequently affects the head, leading to secondary infection. Tinea capitus must also be considered.