Staphylococcal Scalded Skin Syndrome
Staphylococcal Scalded Skin Syndrome is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
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
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 December 7, 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 December 07]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307173/all/Staphylococcal_Scalded_Skin_Syndrome.
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