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Dermatologic Manifestations of Staphylococcal Scalded Skin Syndrome Follow-up

  • Author: Paul Benson, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 16, 2014
 

Further Inpatient Care

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  • Developments in the understanding of the exfoliative toxins of staphylococcal scalded skin syndrome (SSSS) should lead to new and improved diagnostic and therapeutic strategies, including the use of specific antitoxins to prevent exfoliation.[32]
    • Infusing anti-ET antibodies into mice was shown to halt progression of exfoliation in a study performed more than 2 decades ago, but this has never been applied to humans.
    • A recent surge has occurred in reports of methicillin-resistant S aureus strains causing staphylococcal scalded skin syndrome, often with a fatal outcome. These cases emphasize the need to develop alternative treatment strategies before multiple antibiotic resistance becomes a problem.
    • Animal model studies have demonstrated that subinhibitory concentrations of antibiotics such as clindamycin can significantly inhibit toxin production by methicillin-sensitive and methicillin-resistant staphylococcal strains, and antiinflammatory agents such as pentoxifylline can further inhibit activation of the body's inflammatory response to these toxins. Currently, little clinical evidence supports their routine use in the management of staphylococcal scalded skin syndrome.
    • Prevention of progression of staphylococcal scalded skin syndrome by molluscum contagiosum has been observed and indicates possible interference by a viral anticytokine molecule such as interleukin 18 binding protein. The development of drugs based on inflammatory cytokines, including interleukin 18, may be invaluable for halting the progression of severe cases.[33]
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Deterrence/Prevention

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  • Investigate the possibility of a staphylococcal carrier in the vicinity.
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Complications

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  • Cellulitis, sepsis, and pneumonia are possible complications that may occur in children with staphylococcal scalded skin syndrome.
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Prognosis

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  • The prognosis of the disease is good in children, and the mortality rate is low if they are treated.
  • In adult cases of staphylococcal scalded skin syndrome, the mortality rate is high despite appropriate antibiotic therapy.
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Contributor Information and Disclosures
Author

Paul Benson, MD Chief, Program Director, Dermatology Service, Walter Reed Army Medical Center; Associate Professor, Department of Dermatology, Uniformed Services University of the Health Sciences at Bethesda

Paul Benson, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Leonard Sperling, MD Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Jessica H Kim, MD Clinical Assistant Professor, Division of Dermatology, University of Washington School of Medicine; Dermatology Consultant, Cascade Eye & Skin Centers

Jessica H Kim, MD is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, National Psoriasis Foundation, Washington State Medical Association, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

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An infant with characteristic coloring in the skin that looks as though the child has been scalded.
Staphylococcal scalded skin syndrome in an adult.
 
 
 
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