Abstract
Skin lesions of the Staphylococcal Scalded Skin Syndrome (SSSS) caused by ET elaborated by staph infection, are either localized (bullous impetigo) or generalized (toxic epidermal necrolysis). The role of specific ET antibody in determining disease susceptibility was investigated in normal people and in SSSS. Antibody to ET, type A, was measured by radioimmunoassay and bioassay: Anti ET was found only > 8 days in generalized SSSS. 5 children with SSSS 2° to the serologically distinct ET type B were studied. 4 remained anti ET A negative, 1 had high anti ET A levels throughout illness. In 238 normal individuals the % possessing anti ET A increased with age: Anti ET is specific to ET type and develops in response to infection with ET A+staph. Localized SSSS may develop and progress despite antibody while generalized SSSS, due to hematogenous ET dissemination, is prevented by specific anti ET. High prevalence of antibody among persons > 10 yrs. may explain the rarity of generalized SSSS in adults.
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