Staphylococcal scalded skin syndrome
☆ در نتایج Stiftung Warentest 2022 از آلمان، رضایت مصرف کنندگان از ModelDerm فقط اندکی کمتر از مشاوره های پزشکی از راه دور بود.
یک نوزاد با Staphylococcal scalded skin syndrome
References
Staphylococcal Scalded Skin Syndrome وضعیتی است که در آن پوست به دلیل سموم تولید شده توسط انواع خاصی از باکتری های استافیلوکوک ریزش می کند. در کودکان بالای شش سال غیر معمول است. همچنین ممکن است در بزرگسالانی که سیستم ایمنی ضعیفی دارند یا مشکلات کلیوی جدی دارند نیز رخ دهد. ویژگی اصلی لایه برداری گسترده پوست به دنبال التهاب است. شدت آن از چند تاول تا از دست دادن پوست گسترده است که می تواند باعث افت شدید دمای بدن و بی ثباتی در فشار خون شود.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by Staphylococcus aureus. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target S. aureus. These conditions can sometimes be confused with other conditions that result in superficial blistering.
پسر 10 ماهه ای با آبریزش بینی وارد شد و خوب غذا نمی خورد. پزشکان گفتند که این عفونت دستگاه تنفسی فوقانی است. دو روز بعد، او برگشت، زیرا بهبودی نداشت و مشکلات جدیدی مانند تورم صورت و تحریک پوست اطراف دهان داشت. طی دو روز بعد، پسر بدتر شد. دست ها و پاهایش متورم شد و پوستش شروع به کنده شدن کرد. در بازگشت به بیمارستان، پزشکان متوجه بثورات قرمز روی صورت و چین‌های پوست او شدند که در صورت لمس سفید شد. آنها او را staphylococcal scalded skin syndrome (SSSS) تشخیص دادند و از طریق رگ شروع به مصرف آنتی بیوتیک کردند.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
یک دختر 2 ساله به دنبال گزش حشرات روی صورتش در روز قبل با بثورات پوستی در سراسر بدن ظاهر شد که بیش از 48 ساعت ایجاد شده بود. در طول معاینه، بثورات گسترده‌ای متشکل از برجستگی‌های کوچکی داشت که با هم ادغام می‌شدند و هنگامی که به آرامی مالش می‌شد، پوست او نشانه‌های نیکولسکی را نشان می‌داد. هیچ نشانه ای از بثورات روی غشاهای مخاطی او وجود نداشت. آزمایش خون او هیچ نشانه ای از عفونت را نشان نداد.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
این سندرم توسط اگزوتوکسین های اپیدرمولیتیک (اکسفولیاتین) A و B ایجاد می شود که توسط استافیلوکوکوس اورئوس آزاد می شوند. پیش آگهی staphylococcal scalded skin syndrome در کودکان بسیار عالی است، با رفع کامل ظرف 10 روز پس از درمان، و بدون اسکار قابل توجه. با این حال، staphylococcal scalded skin syndrome باید به دقت از نکرولیز سمی اپیدرمی که پیش آگهی بدی دارد افتراق داده شود.
○ تشخیص و درمان
تشخیص اشتباه به عنوان ضایعات اگزما مانند درماتیت آتوپیک و استفاده از پماد استروئیدی باعث تشدید ضایعات می شود. لطفاً هنگام استفاده از پماد آنتی بیوتیک هر چه سریعتر به پزشک مراجعه کنید.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)