The staphylococci. Importance of their control in the management of skin disease.

For skin diseases such as impetigo and furunculosis in which infection with S. aureus is the primary pathologic event, control of that infection is obviously paramount in the management of the clinical situation. The available antistaphylococcal agents are highly effective, and topical mupirocin has been a valuable recent addition. In conditions such as AD the position is less clear. Because the presence of the underlying disease is a prerequisite for the staphylococcal colonization, the exact role of staphylococcal damage is difficult to separate from the underlying disease activity. The definitive experiment, whereby staphylococcal colonization is eradicated over a prolonged period of time by a nonirritant method, remains to be performed. Until that time it is reasonable to pursue a policy of treating S. aureus colonization when it is believed to be of clinical significance and not simply on the basis of bacteriologic findings.