Blisters in bullous impetigo and scalded skin syndrome are caused by:
Exfoliative toxin released by staphylococcus
In bullous impetigo, the blisters are made at what location?
at the local site of infection
in staph scalded skin syndrome (SSSS), the blisters occur where?
throughout the body (due to circulating toxin)
what differentiates staph scalded skin syndrome from SJS?
the blisters involve the skin only, not mucous membranes
what protein does the exfoliative toxin of staph bind to and cleave?
desmoglein 1
what differentiates SSSS and toxic epidermal necrolysis (TEN)?
SSSS involves the epidermis, TEN involves the subepidermis
What is the definition of nikolsky sign?
the dislodgement of epidermis by shearing (rubbing something along the surface recreates the blister)
What is another name for staph scalded skin?
Ritter disease
where do blisters occur in SSSS?
areas of mechanical stress - axilla, flexion areas, buttocks
do scars occur in SSSS?
no. because the cleavage of skin is intraepidermal
how do you diagnose SSSS?
culture blood, urine, nasopharynx, umbilicus or any suspected focus of infection. can also be confirmed by skin biopsy (can differentiate SSSS from TEN)
what is the etiology of toxic epidermonecrolysis? (TEN)
usually a drug reaction
what is the treatment of SSSS?
usually treated with penicillinase-resistant penicillin (oxacillin) or vancomycin (in areas of high MRSA prevalence) + supportive emollients