Abstract
Staphylococcal scalded skin syndrome, a generalized exfoliative dermatitis complicating infections by exfoliative toxin-producing strains ofStaphylococcus aureus, is rarely observed in adults. In contrast to mortality in infants, mortality in adults is usually high. A case of generalized staphylococcal scalded skin syndrome in an immunocompromised woman is reported. Culture of skin biopsy and pleural fluid yielded identical strains ofStaphylococcus aureus belonging to phage group II. Exfoliative toxins A and B were detected in both isolates. As far as can be determined, this is the first reported case of generalized staphylococcal scalded skin syndrome in an adult with detection of exfoliative toxins A and B in which the patient was treated successfully.
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Cribier B, Piemont Y, Grosshans E: Staphylococcal scalded skin syndrome in adults. A clinical review illustrated with a new case. Journal of the American Academy of Dermatology 1994, 39: 319–324.
Lenz, W: Die Staphylokokken-Lysotopie als epidemiologisches Werkzeug. Hygiene und Medizin 1991: 18, 197–214.
Lyell A: Toxic epidermal necrolysis: an eruption resembling scalding of the skin. British Journal of Dermatology 1956, 68: 355–361.
Ritter von Rittershain G: Die exfoliative Dermatitis jüngerer Säuglinge. Centralzeitung Kinderheilkunde 1878, 2: 3–23.
Melish ME, Glasgow LA: The staphylococcal scalded skin syndrome: development of an experimental model. New England Journal of Medicine 1970, 282: 1114–1119.
Birke G, Liljedahl SO, Rajka G: Lyell's syndrome: metabolic and clinical results of a new form of treatment. Acta Dermatology and Venereology 1971, 51: 199–209.
Levine G, Norden CW: Staphylococcal scalded skin syndrome in an adult. New England Journal of Medicine 1972, 287: 1339–1340.
Hawley HB, Aronson MD: Scalded skin syndromes in adults. New England Journal of Medicine 1972, 288: 130.
Rothenberg R, Renna F, Drew T: Staphylococcal scalded skin syndrome in an adult. Archives of Dermatology 1973, 108: 408–410.
Reid L, Weston WL, Humbert JR: Staphylococcal scalded skin syndrome: adult onset in a patient with deficient cell mediated immunity. Archives of Dermatology 1974, 109: 239–241.
Norden CW, Mendelow H: Staphylococcal scalded skin syndrome in adults. New England Journal of Medicine 1974, 290: 577.
Lewis RJ: Scalded skin syndrome in a drug abuser. Journal of the American Medical Association 1974, 230: 375.
Epstein EH, Flynn P, Davis RS: Adult toxic epidermal necrolysis with fatal septicemia. Journal of the American Medical Association 1974, 229: 425–427.
Trentham DE, Silverman HA, Townes AS: Cause of adult toxic epidermal necrolysis. New England Journal of Medicine 1975, 292: 870.
Amon RB, Dimond RL: Toxic epidermal necrolysis: rapid differentiation between staphylococcal and drug induced disease. Archives of Dermatology 1975, 111: 1433–1437.
Achten G, De Dobbeleer G, Moriame M: Staphylococcal scalded skin syndrome in an adult. Dermatologica 1975, 151: 342–348.
Elias PM, Levy SW: Bullous impetigo: occurrence of localized scalded skin syndrome in an adult. Archives of Dermatology 1976, 112: 856–858.
Sturman SW, Malkinson FD: Staphylococcal scalded skin syndrome in an adult and a child. Archives of Dermatology 1976, 112: 1275–1279.
Schlesinger JJ: Staphylococcal induced toxic epidermal necrolysis in an adult: case report. Military Medicine 1977, 142: 791–793.
Peterson PK, Laverdiere M, Quie PG: Abnormal neutrophil chemotaxis and T-lymphocyte function in scalded skin syndrome in an adult patient. Infection 1977, 5: 128–131.
Neefe LI, Tuazon CV, Cardella TA, Sheagren JN: Staphylococcal scalded skin syndrome in adults: case report and review of the literature. American Journal of the Medical Sciences 1979, 277: 99–110.
Ridgway HB, Lowe NJ: Staphylococcal scalded skin syndrome in an adult with Hodgkin's disease. Archives of Dermatology 1979, 115: 589–590.
Fine JD, Harrist TJ, Radford MJ: Adult scalded skin syndrome fatally complicated by mixed gram-negative sepsis and cellulitis. Cutis 1981, 27: 162–167.
Diem E, Konrad K, Graninger W: Staphylococcal scalded skin syndrome in an adult with fatal disseminated sepsis. Acta Dermatology and Venereology 1982, 62: 295–299.
Janier M, Bigel ML, Wallach D: Staphylococcie exfoliante et pustuleuse géneralisée chez une immunodéprimée. Annals of Dermatology and Venereology 1984, 111: 705–706.
Richard M, Matthieu-Serra A: Staphylococcal scalded skin syndrome in a homosexual adult. Journal of the American Academy of Dermatology 1986, 15: 385–389.
Takiushi I, Sakasi H, Tagaki H: Staphylococcal scalded skin syndrome in an adult. Journal of Dermatology 1986, 13: 372–376.
O'Keefe R, Dag JH, MacKie RM: The staphylococcal scalded skin syndrome in two elderly immunocompromised patients. British Medical Journal 1987, 295: 179–180.
Opal SM, Johnson-Winegar AD, Cross AS: Staphylococcal scalded skin syndrome in two immunocompetent adults caused by exfoliative B-producingStaphylococcus aureus. Journal of Clinical Microbiology 1988, 26: 1283–1286.
Saiag R Caumes E, Roujeau JC: Epidermolyse staphylococcique (syndrome de Lyell staphylococcique) de I'adult: 2 cas. Annals of Dermatology and Venereology 1988, 115: 1164–1166.
Petzelbauer P, Konrad K, Wolff K: Staphylococcal scalded skin syndrome in 2 adults with acute kidney failure. Hautarzt 1989, 40: 90–93.
Goldberg NS, Ahmed T, Robinson B, Ascensao J, Horowitz H: Staphylococcal scalded skin syndrome mimicking acute graft-vs.-host disease in a bone marrow transplant recipient. Archives of Dermatology 1989, 125: 85–87.
Beers B, Wilson B: Adult staphylococcal scalded skin syndrome. International Journal of Dermatology 1990, 29: 428–429.
Herzog JL, Sexton M: Desquamative rash in an immunocompromised adult. Archives of Dermatology 1990, 26: 815–819.
Strumia R, Bedetti A, Cavazzini L: Staphylococcal scalded skin syndrome in AIDS. Journal of Italian Dermatology and Venereology 1990, 125: 461–464.
Donohue D, Robinson B, Goldberg NS: Staphylococcal scalded skin syndrome in a woman with chronic renal failure exposed to human immunodeficiency virus. Cutis 1991, 47: 317–318.
Khuong MA, Chosidow O, El Solh N, Wechsler J, Piemont Y, Roujeau JC, Revuz J: Staphylococcal scalded skin syndrome in an adult: possible influence of non-steroidal anti-inflammatory drugs. Dermatology 1993, 186: 153–154.
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Roeb, E., Schönfelder, T., Matern, S. et al. Staphylococcal scalded skin syndrome in an immunocompromised adult. Eur. J. Clin. Microbiol. Infect. Dis. 15, 499–503 (1996). https://doi.org/10.1007/BF01691318
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DOI: https://doi.org/10.1007/BF01691318