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    Staphylococcal Scalded Skin Syndrome

    Staphylococcal Scalded Skin Syndrome is a topic covered in the 5-Minute Emergency Consult.

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    Emergency Central

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    Basics

    Description

    • Results from the actions of a soluble epidermolytic exotoxin produced by Staphylococcus aureus:
      • Produced at a distant site of infection or colonization
      • Disseminates hematogenously
      • Lyses desmosomes of granular cells in the superficial epidermis
      • Results in generalized intradermal exfoliation
    • Typically affects infants and children <6 yr of age:
      • Adults have specific staph antibodies allowing them to localize, metabolize, and excrete the staph toxins.
      • Infants and children are unable to metabolize and excrete toxin efficiently.
      • Immunocompromised adults and those with severe renal dysfunction are also susceptible
    • Presentation determined by age and extent of rash:
      • Classic staphylococcal scalded skin syndrome
      • Pemphigus neonatorum
      • Bullous impetigo
      • Generalized in the newborn: Ritter disease
    • Typically, coagulase-positive phage group II Staphylococcus:
      • Phage groups I and III also implicated

    Etiology

    • Colonization often without overt infection
    • Concurrent infection or break of skin barrier:
      • Nasopharynx
      • Urinary tract
      • Minor skin abrasions
      • Circumcision site
      • Conjunctivitis
      • Umbilicus/omphalitis
      • Impetigo
      • Endocarditis and septicemia
    • Often no focus identified

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    Citation

    Rosen, Peter, et al., editors. "Staphylococcal Scalded Skin Syndrome." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome.
    Staphylococcal Scalded Skin Syndrome. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome. Accessed April 24, 2019.
    Staphylococcal Scalded Skin Syndrome. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome
    Staphylococcal Scalded Skin Syndrome [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome.
    * Article titles in AMA citation format should be in sentence-case
    TY - ELEC T1 - Staphylococcal Scalded Skin Syndrome ID - 307173 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -