Staphylococcal Scalded Skin Syndrome Discussion

Introduction

Staphylococcal scalded skin syndrome (SSSS) is a serious skin infection that primarily affects children and immunocompromised individuals (Philip & Lucey, 2019). In this paper, the author discusses the pathophysiology, presentation, diagnosis, and treatment of staphylococcal scalded skin syndrome.

Pathophysiology

The infection is caused by the strain of bacteria, staphylococcus aureus. The bacteria produce exotoxins that invade the zona glomerulosa layer of the epidermis. These bacteria affect a complex present in the superficial epidermis called desmoglein, which is responsible for the adhesion of cells, giving the skin its integrity (Paller & Mancini, 2020).  This results in skin exfoliation, which may be localized or involve the entire body. The bacteria mostly affect children because adults have antibodies against the toxins and thus are rarely affected unless they are immunocompromised. Staphylococcal Scalded Skin Syndrome Discussion

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Presentation

The initial presentation of the condition includes fever, malaise, and irritability. It then presents with an erythematous rash that spreads from the face and flexor surfaces like the axilla and the neck (Ross & Shoff, 2022). The rash becomes tender blisters that ooze yellow pus. This leads to breakage and skin exfoliation. The infection may also lead to sepsis, hypotension, and shock.

Diagnosis

The diagnosis involves various tests that detect the infectious process and rule out other conditions that might present the same way. Diagnosis includes evaluation of the patient’s signs and symptoms for the above features, physical examination, and laboratory studies (Ross & Shoff, 2022). A definite diagnosis can be made through a skin biopsy, which is examined under a microscope to confirm the diagnosis and differentiate it from other conditions like toxic shock syndrome (Philip & Lucey, 2019). Blood, urine, and skin cultures can also help in the diagnosis. A complete blood count with differential helps rule out sepsis. Staphylococcal Scalded Skin Syndrome Discussion

Treatment

It requires early detection and treatment with antibiotics that cover staphylococcus aureus such as Cefazolin or Oxacillin. For methicillin-resistant staphylococcus aureus (MRSA) Vancomycin is the drug of choice (Ross & Shoff, 2022). Intravenous fluids should also be given to those with dehydration and suspected sepsis. Dressings should be applied to the surface to prevent heat loss and promote wound healing. Other supportive care such as nutritional support and temperature regulation are also helpful in promoting the healing process (Verma & Vasudevan, 2021). Staphylococcal Scalded Skin Syndrome Discussion

References

Paller, A. S., & Mancini, A. J. (2020). Paller and Mancini – Hurwitz clinical pediatric dermatology E-book: A textbook of skin disorders of childhood and adolescence. Elsevier Health Sciences.

Philip, R., & Lucey, A. (2019). Staphylococcus scalded skin syndrome outbreak in the neonatal intensive care unit. American Journal of Infection Control, 47(6), S36. https://doi.org/10.1016/j.ajic.2019.04.081

Ross, A., & Shoff, H. W. (2022, July 26). Staphylococcal scalded skin syndrome – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK448135/

Verma, R., & Vasudevan, B. (2021). Dermatological emergencies.  Staphylococcal Scalded Skin Syndrome Discussion