Staph Scalded skin syndrome

Question 1

Etiology

Answer 1

S aureus producing exfoliatice toxins

Question 2

Pathogenesis

Answer 2

Illness develops after toxin synthesis and the subsequent toxin-initiated host response.
Exotoxins (Exfoliatin) cleave desmoglein-1 in epidermal granular cell-layer, resulting in its separation.

Question 3

clinical manifestation

Answer 3

LOCALIZED FORM See “Bullous Impetigo” Intact flaccid purulent bullae,clustered.
Rupture of the bulla results in moist red and/or crusted erosive lesions.
Lesions are often clusted in an intertrigenous area. .

GENERALIZED FORM Exfoliative toxin-induced changes: macular scarlatiniform rash (staphy- lococcal scarlet fever syndrome)or diffuse,ill- defined erythema and a ne, stippled, sandpaper appearance occur initially. In 24 h, erythema deepens and involved skin becomes tender. Ini- tially,periorifcially on face,neck,axillae,groins; becoming more widespread in 24 to 48 h.
Superficial epidermis is most pronounced periorificially on face; in flexural areas on neck, axil- lae, groins, and antecubital areas; back (pressure points). With epidermolysis, epidermis appears wrinkled and can be removed by gentle pressure (skin resembles wet tissue paper) (Nikolsky sign). In some in ants, flaccid bullae occur. Unroofed epidermis forms erosions with red, moist base. Desquamation occurs with healing

Question 4

How many days will denuded areas hea? Will there be scarring?

Answer 4

No scarring

3-5 days to heal

Question 5

Treatment

Answer 5

systemic antibiotic

Question 6

Positive w what sign?

Answer 6

Nikolsky sign

Question 7

Positive w what sign

Answer 7

Pastia sign

Question 8

What spots are seen on mucosa

Answer 8

Forscheimmer spots

Question 9

Treatment

Answer 9

Systemic penicillin is the drug of choice;

alternatives are erythromycin, clindamycin,
clarithromycin,
cephalosporins

Question 10

Complications

Answer 10

Acute rheumatic fever 1 to 4 weeks after onset of pharyngitis.
acute glomerulonephritis