And then the last one that was on our list
was staphylococcal scalded skin syndrome.
Now this is a toxin-mediated
epidermolytic disease, as opposed
to an immune-mediated disease.
And it is a, essentially, generalized
form of bullous impetigo.
Bullous impetigo, also caused
by Staph or Strep,
and those are basically small vesicles
that we'll see around the lips
or the chin or the perioral area,
particularly in kids.
This is a much more extensive
generalized version of that.
It's essentially caused by
the systemic absorption
of something called exfoliative toxin,
which binds to desmoglein-1. Again, that's in
the epidermis, and it's causing
and you're going to, again, have
those thin-walled, very fragile
bullae and vesicles. Rapidly progressive.
Can occur over the matter of
hours to days. And
the big difference, and the reason that this
condition is not high on our list for our patient,
is that it really is only occurring in kids.
Now, importantly, unlike some
of those other conditions
we mentioned, like Stevens-Johnson
pemphigus vulgaris, staphylococcal
scalded skin syndrome tends
to not involve the mucosa,
even though it can be pretty significant
in the non-mucosal skin.
It will resolve spontaneously
within 5-7 days,
so you're really just providing supportive
care; systemic antibiotics, if needed,
and ensuring hydration and
all those sorts of things.
But the real factor that's
going to lead us away
from staphylococcal scalded skin syndrome
in our 71-year-old woman
is the fact that this is a disease
of kids, really babies.
It's not something you're going to see
in adults, let alone the geriatric population.