Dermatology
Staph Scalded Skin Syndrome
포도상구균 열상피부증후군
S. aureus exotoxin separates epidermis (pediatric emergency)
- How common
- Pediatric emergency
- Typical age
- <5 yrs
What is it?
S. aureus exfoliative toxin cleaves desmoglein-1, causing intraepidermal split.
Commonly affected: Whole skin (mucosa spared)
How it develops
- Focal infectionNose, conjunctiva, pharynx focus
- Toxin releaseETA/ETB enter bloodstream
- Dsg-1 cleavageDisrupts epidermal adhesion
- SloughingPositive Nikolsky sign
Symptoms
- Diffuse erythemaPainful red skin starting in flexures
- Positive NikolskyRubbing produces epidermal slough
- Fever/irritabilitySudden high fever
- Mucosa sparedOral and conjunctival mucosa intact
How it is examined
- Child rash + feverConfirm positive Nikolsky
- Source cultureNose/pharynx culture
Imaging
Imaging not needed; clinical diagnosis.
- Clinical
Sepsis workup if indicated.
- Blood culture
Non-surgical care
- Admit and fluidsFluid/electrolyte support
- Antistaph antibioticsIV nafcillin/oxacillin
- Burn-like skin careTreat like a burn
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
None
Outlook
Pediatric mortality <5% with treatment; adult worse.