Staphylococcal-scalded skin syndrome, a clinical case

Abstract

Staphylococcal scalded skin syndrome (SSSS) is the most severe form of staphyloderma in newborns and young children. The disease is associated with the production of exfoliatin toxin by Staphylococcus aureus, which breaks down desmoglein 1 in the cells of the granular layer of the epidermis, which leads to the formation of superficial blisters. The differential diagnosis is with toxic epidermal necrolysis (Lyells syndrome, TEN). The development of TEN is more often associated with the use of drugs such as sulfonamides, anticonvulsants, antibiotics, etc. As an illustration of the difficulty of differential diagnosis, we present our clinical observation of a 1-year-old girl. The girl was admitted in serious condition to the intensive care unit with a diagnosis of Lyells syndrome. At the admission, extensive skin lesions were noted in the form of multiple flaccid blisters and erosions. At the same time, the mucous membranes were not affected. The department was diagnosed with staphylococcal scalded skin syndrome. Thus, the differential diagnosis of the syndrome of SSSS and TEN presents certain difficulties. When making a diagnosis, it is necessary to take into account the anamnesis, clinical manifestations, paying special attention to the defeat of the mucous membranes.