By Disease Name > Staph Scalded Skin Syndrome

Staph Scalded Skin Syndrome

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majority of patients <5 years old
failure to adequately clear the toxin appears to predispose the very young (and those with renal failure)
pathogen = phage group II, type 71 S. aureus colonizing "somewhere", but toxin mediated (therefore you probably won't culture it from a blister)
exfoliative toxins A and B (ETA and ETB)
may not act as superantigen
postulated to cause blistering in the granular layer by directly binding desmoglein 1
an appropriate antibody response to ET appears to limit clinical disease expression to bullous impetigo; an inadequate response may predispose patients to development of SSSS
accentuation in flexural areas, sterile blisters,
very superficial (sub-corneal);Nikolskys sign
intraoral lesions do not occur because of the absence of a granular layer to which the toxin may bind;  however involvement of the keratinized external lip with crusting and fissuring is frequently encountered