Dr. Sean Coulson
Staph scalded skin syndrome – A systemic manifestation of an initially isolated lesion
- Bacterial toxin that cleaves dermal proteins that typically affects kids (0 – 6 years old) or older adults w/ renal dysfunction
- Typically will start as an isolated dermal insult wh(cellulitis, impetigo etc) and progress to SSSS
Risk factors:
- Renal dysfunction – toxins build up and are renally excreted
- Immunosuppression
Clinical Features
- Diffuse progressive cutaneous blanching erythema, bullae which desquamate, crusting and systemic symptoms. (+) Nikolskies sign
- Typically does NOT involve mucus membranes
- Diffuse symptoms typically being in skin folded areas.
Differential Diagnosis
SJS / TEN
Kawasaki
DRESS
Thermal Burn
Bullous impetigo
Toxic Shock Syndrome
Scarlet Fever
Management
- IV abx: Vancomycin +/- toxin inhibition with clindamycin
- Supportive and wound care
EMRAP
