SSSS Flashcards
What do you call generalized SSSS in neonates?
Ritter Disease
Exfoliative toxins (ETs)
are made by certain strains of S. aureus (usually PHAGE group 2)
Exfoliatin A and B
are 2 serologically distinct proteins produced by S. aureus
What are exfoliative toxins?
They are serine proteases
They bind to the cell-adhesion molecule DESMOGLEIN 1 and cleave it resulting in a loss of cell to cell adhesion
where is desmoglein-1 protein expression found?
it is in the upper part of the epidermis
Consistent with the pattern of desmoglein-1 protein expression, which is found in the upper part of the epidermis
the epidermolysis takes place usually between the stratum spinosum and granulosum resulting in a very thin walled flaccid blister that is easily disrupted, exhibiting a (+) Nikolsky sign
The pathophysiology of Exfoliative toxin resembles that of the autoimmune blistering disease pemphigus foliaceus, with both diseases targeting desmoglein-1
Presumably, staphylococcal bacteria have evolved this toxin to allow the bacteria to proliferate and spread beneath the stratum corneum barrier of the skin
There are 2 forms of exfoliative toxin mediated disease:
- localized bullous impetigo
2.Systemic SSSS
Studies suggest that majority of localized bullous impetigo are caused by?
Exfoliative toxin A
Studies suggest that systemic forms, such as SSSS are caused by?
Exfoliative toxin B (possibly because of a lower titer of anti-ETB-neutralizing antibodies in the general population)
What is the cause of the outbreaks of SSSS?
Neonatal or maternity hospital staff colonized or infected with ET producing staphylococci is the source of these outbreaks
Although more commonly seen in infants and children
SSSScan also be seen in adults
What are the risks for adults to develop SSSS?
1) compromised immune response allowing for growth of the S. aureus
2) impaired amou
