Staphylococcal scalded skin syndrome in an adult with Hodgkin's disease

Ridgway, H. B.

doi:10.1001/archderm.115.5.589

Cited by 7 publications

(6 citation statements)

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“…aureus from blood cultures (Table ) . In addition, as opposed to paediatric patients who are usually in otherwise good health when they develop SSSS, virtually all adults with SSSS were immunocompromised, with chronic renal disease, HIV infection, graft‐versus‐host disease, malignant neoplasms, chemotherapy, intravenous drug abuse or diabetes mellitus . Similar to paediatric patients, adults with SSSS demonstrate a fever, and oedematous erythema of the eyelids and nostrils.…”

Section: Clinical Features In Adultsmentioning

confidence: 99%

Staphylococcal scalded skin syndrome: diagnosis and management in children and adults

Handler

Schwartz

2014

Acad Dermatol Venereol

127

135

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Staphylococcal scalded skin syndrome is a potentially life-threatening disorder caused most often by a phage group II Staphylococcus aureus infection. Staphylococcal scalded skin syndrome is more common in newborns than in adults. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. The diagnosis can be confirmed by a skin biopsy specimen, which can be expedited by frozen section processing, as staphylococcal scalded skin syndrome should be distinguished from life threatening toxic epidermal necrolysis. Histologically, the superficial epidermis is detached, the separation level being at the granular layer. The diffuse skin loss is due to a circulating bacterial exotoxin. The aetiological exfoliating toxin is a serine protease that splits only desmoglein 1. The exfoliative toxins are spread haematogenously from a localized source of infection, causing widespread epidermal damage at distant sites. Sepsis and pneumonia are the most feared complications. The purpose of this review is to summarize advances in understanding of this serious disorder and provide therapeutic options for both paediatric and adult patients. Recent epidemiological studies have demonstrated that paediatric patients have an increased incidence of Staphylococcal scalded skin syndrome during the summer and autumn. Mortality is less than 10% in children, but is between 40% and 63% in adults, despite antibacterial therapy. Previously, intravenous immunoglobulin had been recommended to combat Staphylococcal scalded skin syndrome, but a recent study associates its use with prolonged hospitalization.

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Section: Clinical Features In Adultsmentioning

confidence: 99%

Staphylococcal scalded skin syndrome: diagnosis and management in children and adults

Handler

Schwartz

2014

Acad Dermatol Venereol

127

135

View full text Add to dashboard Cite

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“…(18) reported that, in adult cases of SSSS, bullae were not generally sterile. In fact, adult cases of SSSS exhibiting sterile bullae have only rarely been reported (15). In our patient, staphylococci were not isolated from the throat culture, but were found in smears of fluids from native pustules which developed around the herpes zoster lesion.…”

Section: Since Melish and Glasgowmentioning

confidence: 50%

“…Since the use of antibiotics, the mortality rate in children has markedly decreased. In contrast, the rate in adults is as high as 50% due to the severe underlying diseases (15) such as leukemia (6), Hodgkin's disease (12,15) and chronic renal disease (2,8). With the exception of herpes zoster, our patient had no severe underlying disease.…”

Section: Since Melish and Glasgowmentioning

confidence: 74%

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Staphylococcal Scalded Skin Syndrome in an Adult

Takiuchi

Sasaki

Takagi

et al. 1986

The Journal of Dermatology

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We report a case of a 77‐year‐old man with staphylococcal scalded skin syndrome (SSSS). The patient, who had no physical abnormalities other than herpes zoster, showed intact humoral and cellular immunity. A 3‐ and 1‐phage group strain of Staphylococcus aureus was isolated from an unruptured pustule of the herpes zoster lesion, but not from the throat. Inoculation of the isolated bacterium into newborn mice produced a characteristic Nikolsky sign. Histological diagnosis of SSSS was established by findings of intraepithelial cleavage through the stratum granulosum and a lack of inflammatory cells in both dermis and epidermis. After a ten‐day course of oral cefaclor (250 mg every 8 hours) and topical triamcinolone acetonide containing fradiomycin and gramycidin J, the patient recovered completely. The patient left the hospital without any scars other than those of herpes zoster.

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“…Although SSSS is typically a disease of children, it can also be seen in adults, especially in those with chronic renal insufficiency or the immunosuppressed. [46] Diffuse skin sloughing can be quite dramatic and a rapid diagnosis is often required. Skin biopsies with a hematoxylin and eosin stain or even frozen section can be time consuming.…”

Section: Skin Syndromementioning

confidence: 99%

Reintroducing the Tzanck Smear

Kelly

Shimoni

2009

American Journal of Clinical Dermatology

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The Tzanck smear is a rapid and simple technique that can be performed in the clinic or doctor's office with minimal patient discomfort or cost. It is known to most dermatologists as a rapid test for diagnosing herpes virus infections. Its use, however, can be more widely applied, including in the diagnosis of pustular diseases of the newborn, cutaneous infections, vesiculobullous diseases, and non-melanoma skin cancers. Material is gently scraped from the base of a vesicle, blister, or pustule or directly from the lesion or tumor. Typically, the material is allowed to air dry after which it can then be stained with a variety of stains, including Giemsa, toluidine blue, and methylene blue. The Tzanck smear should not be used to replace more standard diagnostic techniques, but rather as an adjunct to the physical examination.

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Staphylococcal scalded skin syndrome in an adult with Hodgkin's disease

Cited by 7 publications

References 0 publications

Staphylococcal scalded skin syndrome: diagnosis and management in children and adults

Staphylococcal scalded skin syndrome: diagnosis and management in children and adults

Staphylococcal Scalded Skin Syndrome in an Adult

Reintroducing the Tzanck Smear

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