Staphylococcal scalded skin syndrome - 포도알균 열상피부증후군
References
Staphylococcal Scalded Skin Syndrome 은 특정 유형의 포도상구균 박테리아가 생성하는 독소로 인해 피부가 벗겨지는 상태입니다. 6세 이상의 어린이에게는 흔하지 않습니다. 또한 면역 체계가 약하거나 심각한 신장 문제가 있는 성인에게서도 발생할 수 있습니다. 주요 특징은 염증 후 피부가 광범위하게 벗겨지는 것입니다. 심각도는 몇 개의 물집부터 광범위한 피부 손실까지 다양하며 이로 인해 체온이 크게 떨어지고 혈압이 불안정해질 수 있습니다.
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.
10개월 된 남자아이가 콧물이 흐르고 밥도 잘 먹지 않아서 찾아왔습니다. 의사들은 상부 호흡기 감염이라고 말했습니다. 이틀 후, 상태가 호전되지 않고 얼굴이 부어오르고 입 주변 피부가 따끔거리는 등의 새로운 문제가 생겨 다시 내원하였습니다. 그 후 이틀 동안 소년의 상태는 더욱 악화되었습니다. 그의 팔과 다리는 부어오르고 피부는 벗겨지기 시작했습니다. 병원으로 돌아온 의사들은 그의 얼굴과 피부 주름에 붉은 발진이 생겼고, 만지면 희게 변하는 것을 발견했습니다. 그들은 그를 staphylococcal scalded skin syndrome (SSSS) 으로 진단하고 정맥을 통해 항생제 치료를 시작했습니다.
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.
2세 여아가 전날 얼굴에 벌레 물린 후 48시간에 걸쳐 온몸에 발진이 생겼습니다. 검사 중에 그녀는 작은 돌기가 서로 합쳐진 광범위한 발진이 있었고 가볍게 문지르면 피부에 니콜스키 징후가 나타났습니다. 그녀의 점막에 영향을 미치는 발진의 징후는 없었습니다. 그녀의 혈액 검사에서는 감염 징후가 나타나지 않았습니다.
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.
이 증후군은 황색포도상구균(S. aureus)에 의해 분비되는 표피 용해성 외독소(각질제거) A와 B에 의해 유발됩니다. 소아에서 포도알균 열상피부증후군 (staphylococcal scalded skin syndrome) 의 예후는 치료 후 10일 이내에 완전히 해소되고 심각한 흉터도 남지 않을 정도로 우수합니다. 그러나 포도알균 열상피부증후군 (staphylococcal scalded skin syndrome) 은 예후가 좋지 않은 독성표피괴사용해증과 주의 깊게 감별해야 한다.
○ 진단 및 치료
아토피성 피부염 등 습진 병변으로 오진하고, 스테로이드 연고를 바르면 병변이 악화된다. 항생제 연고를 바르는 동안에는 가능한 한 빨리 의사의 진료를 받으시기 바랍니다.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)