Staphylococcal scalded skin syndrome - Revision history

Rossdonaldson1: /* Background */

2024-12-11T18:15:21Z

Background

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	==Background==		==Background==
			{{Skin anatomy background images}}
	*Caused by [[Staph aureus]]		*Caused by [[Staph aureus]]
	*Bacteria release exotoxin which breaks down desmosomes		*Bacteria release exotoxin which breaks down desmosomes

2021-02-13T17:49:59Z

Antibiotic Options

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	*If possible [[MRSA]]:		*If possible [[MRSA]]:
	**[[Clindamycin]] 40mg/kg/d IV or PO in 4 divided doses x7-10d		**[[Clindamycin]] 40mg/kg/d IV or PO in 4 divided doses x7-10d
			***Reports of high clindamycin resistance in SSSS<ref>Braunstein I, Wanat KA, Abuabara K, McGowan KL, Yan AC, Treat JR. Antibiotic sensitivity and resistance patterns in pediatric staphylococcal scalded skin syndrome. Pediatr Dermatol. 2014;31(3):305-308. doi:10.1111/pde.12195</ref>
	**[[Bactrim]] 10mg/kg/d in 2 divided doses x7-10d		**[[Bactrim]] 10mg/kg/d in 2 divided doses x7-10d
	**[[Vancomycin]] 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr		**[[Vancomycin]] 10-15mg/kg/d in 2 divided doses up to 1 gm q12hr

2021-02-13T17:49:06Z

Antibiotic Options

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	===[[Antibiotic]] Options===		===[[Antibiotic]] Options===
	*[[Nafcillin]] 100mg/kg/d IV in 4 divided doses '''OR''' 50mg/kg/d in 4 divided doses PO x7-10d		*[[Nafcillin]] 100mg/kg/d IV in 4 divided doses '''OR''' 50mg/kg/d in 4 divided doses PO x7-10d
			*[[Dicloxacillin]] 125-500mg PO q6h x7-10 days
	*[[Penicillin G Procaine]] (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)		*[[Penicillin G Procaine]] (300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg)
	*[[Amoxicillin/Clavulanate]] 45mg/kg/d PO in 2 divided doses x 7-10d		*[[Amoxicillin/Clavulanate]] 45mg/kg/d PO in 2 divided doses x 7-10d

2021-02-09T21:28:32Z

2021-02-09T21:26:53Z

Clinical Features

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	[[File:OSC Microbio 21 02 SSSS.jpg\|thumb\|Infant with Staphylococcal scalded skin syndrome]]		[[File:OSC Microbio 21 02 SSSS.jpg\|thumb\|Infant with Staphylococcal scalded skin syndrome]]
	[[File:PMC3807844 CRIM.DM2013-376060.001.png\|thumb\|]]		[[File:PMC3807844 CRIM.DM2013-376060.001.png\|thumb\|]]
	*[[Rash]] progresses from erythroderma to extensive areas of exfoliation		*[[Rash]] progresses from erythroderma (classically perioral) to extensive areas of exfoliation
	*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common		*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common
	*Nikolsky sign (separation of epidermis when pressure is applied) is present		*Nikolsky sign (separation of epidermis when pressure is applied) is present

2021-02-09T21:25:37Z

Background

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	==Background==		==Background==
	*Caused by [[Staph aureus]]		*Caused by [[Staph aureus]]
			*Bacteria release exotoxin which breaks down desmosomes
			**Exotoxin spread via bloodstream, therefore blisters not infected
	*Most patients <2yr old, nearly all <6 yr old		*Most patients <2yr old, nearly all <6 yr old

2019-11-16T12:54:21Z

Clinical Features

← Revisión anterior		Revisión del 12:54 16 nov 2019
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	==Clinical Features==		==Clinical Features==
	[[File:OSC Microbio 21 02 SSSS.jpg\|thumb\|Infant with Staphylococcal scalded skin syndrome]]		[[File:OSC Microbio 21 02 SSSS.jpg\|thumb\|Infant with Staphylococcal scalded skin syndrome]]
			[[File:PMC3807844 CRIM.DM2013-376060.001.png\|thumb\|]]
	*[[Rash]] progresses from erythroderma to extensive areas of exfoliation		*[[Rash]] progresses from erythroderma to extensive areas of exfoliation
	*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common		*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common

2019-11-16T12:44:48Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:OSC Microbio 21 02 SSSS.jpg\|thumb\|Infant with Staphylococcal scalded skin syndrome]]
	*[[Rash]] progresses from erythroderma to extensive areas of exfoliation		*[[Rash]] progresses from erythroderma to extensive areas of exfoliation
	*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common		*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common

2019-10-31T17:35:09Z

2019-10-06T20:39:58Z

← Revisión anterior		Revisión del 20:39 6 oct 2019
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	==Clinical Features==		==Clinical Features==
	*[[Rash]] progresses from erythroderma to extensive areas of exfoliation		*[[Rash]] progresses from erythroderma to extensive areas of exfoliation
	*Systemic symptoms (malaise, fever, irritability, skin tenderness) are common		*Systemic symptoms (malaise, [[fever]], irritability, skin tenderness) are common
	*Nikolsky sign (separation of epidermis when pressure is applied) is present		*Nikolsky sign (separation of epidermis when pressure is applied) is present
	*No mucous membrane involvement (differentiate from [[SJS]]/TENS)		*No mucous membrane involvement (differentiate from [[SJS]]/TENS)
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	==Evaluation<ref>Randall WK et al. Staphylococcal Scalded Skin Syndrome Workup. eMedicine. Oct 28, 2015. http://emedicine.medscape.com/article/788199-workup.</ref>==		==Evaluation<ref>Randall WK et al. Staphylococcal Scalded Skin Syndrome Workup. eMedicine. Oct 28, 2015. http://emedicine.medscape.com/article/788199-workup.</ref>==
	*PCR for toxin if available		*PCR for toxin if available
	*CBC - leukocytosis, though normal WBC level oftenly		*CBC - [[leukocytosis]], though normal WBC level oftenly
	*ESR elevation		*ESR elevation
	*Monitor electrolytes, renal function closely in severe disease		*Monitor electrolytes, renal function closely in severe disease
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	[[Category:Dermatology]]		[[Category:Dermatology]]
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
			[[Category:ID]]

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	==See Also==		==See Also==
	*[[Staphylococcus aureus]]		*[[Staphylococcus aureus]]

			==External Links==
			[https://pedemmorsels.com/staph-scalded-skin-syndrome/ Pediatric EM Morsels: Staph Scalded Skin Syndrome]

	==References==		==References==