Staphylococcal Scalded Skin Syndrome

00:02 And then the last one that was on our list was staphylococcal scalded skin syndrome.

00:06 Now this is a toxin-mediated epidermolytic disease, as opposed to an immune-mediated disease.

00:13 And it is a, essentially, generalized form of bullous impetigo.

00:18 Bullous impetigo, also caused by Staph or Strep, and those are basically small vesicles that we'll see around the lips or the chin or the perioral area, particularly in kids.

00:28 This is a much more extensive generalized version of that.

00:31 It's essentially caused by the systemic absorption of something called exfoliative toxin, which binds to desmoglein-1. Again, that's in the epidermis, and it's causing intra-epidermal acantholysis, and you're going to, again, have those thin-walled, very fragile bullae and vesicles. Rapidly progressive. Can occur over the matter of hours to days. And the big difference, and the reason that this condition is not high on our list for our patient, is that it really is only occurring in kids.

01:04 Now, importantly, unlike some of those other conditions we mentioned, like Stevens-Johnson syndrome and pemphigus vulgaris, staphylococcal scalded skin syndrome tends to not involve the mucosa, even though it can be pretty significant in the non-mucosal skin.

01:21 It will resolve spontaneously within 5-7 days, so you're really just providing supportive care; systemic antibiotics, if needed, and ensuring hydration and all those sorts of things.

01:32 But the real factor that's going to lead us away from staphylococcal scalded skin syndrome in our 71-year-old woman is the fact that this is a disease of kids, really babies.

01:42 It's not something you're going to see in adults, let alone the geriatric population.