Staphylococcal scalded skin syndrome - 葡萄球菌性烫伤皮肤综合征
relevance score : -100.0%
ReferencesStaphylococcal Scalded Skin Syndrome 是由某些类型的葡萄球菌产生的毒素引起的皮肤脱落疾病。该病在六岁以上的儿童中并不常见，也可能出现在免疫功能低下或患有严重肾脏疾病的成人中。其主要表现为炎症后出现大面积皮肤脱屑，严重时可出现多个水泡或广泛的皮肤剥脱，甚至导致体温显著下降和血压不稳。
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.
一名 10 个月大的男孩进来，流鼻涕，吃得不好。医生说这是上呼吸道感染。两天后，他回来了，因为他的情况没有好转，并且出现了新的问题，例如脸部肿胀和口腔周围皮肤发炎。接下来的两天里，男孩的病情越来越严重。他的胳膊和腿肿胀起来，皮肤开始脱落。回到医院后，医生发现他的脸上和皮肤皱褶处出现红色皮疹，一碰就会变白。他们诊断他患有 staphylococcal scalded skin syndrome (SSSS) ，并开始通过静脉注射抗生素。
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.
一名 2 岁的女孩在前一天被昆虫叮咬后，48 小时内全身出现皮疹。检查时，发现她有大范围的皮疹，呈融合的小结节，轻轻擦拭皮肤可出现Nikolsky sign（尼科尔斯基征）。未见皮疹累及粘膜。血液检查未见感染迹象。
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.
该综合征由金黄色葡萄球菌分泌的表皮松解性外毒素（剥落素）A 和 B 引起。儿童葡萄球菌性烫伤皮肤综合征 (staphylococcal scalded skin syndrome) 预后极好，治疗后10天内可完全消退，且通常不留明显疤痕。但必须仔细鉴别葡萄球菌性烫伤皮肤综合征 (staphylococcal scalded skin syndrome) 与预后较差的中毒性表皮坏死松解症。
○ 诊断和治疗
误将其诊断为特应性皮炎等湿疹可导致使用类固醇软膏加重病情。出现症状时应及时就医，并使用抗生素软膏治疗。
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)