PATHOPHYSIOLOGY of STAPHYLOCOCCAL SCALDED SKIN SYNDROME (SSSS)

PREDISPOSING FACTORS PRECIPITATING FACTORS

> Environment > Poor hand hygiene
> Weak Immune system
> Poor renal clearance

S. Aureus produces exotoxins (Epidermolytic A and B) in the skin

Exotoxins produces serine proteases

This cleaves the desmosomal proteins desmoglein 1 in the zona granulosa of the epidermis

Causing keratinocytes to detach from one another

and from the underlying basement membrane

S/Sx:
(+)skin exfoliation Exfoliation of the skin Blisters
(diffuse sheetlike desquamation) (thin walled, sterile cloudy fluid to
frank yellow pus fluid-filled bullae)

Rupture of lesions leaves denuded skin

(also known as Nikolsky’s Sign)

S/Sx:
rash, heat, pain Local Inflammatory Response of the body

Exofoliative toxins are spread hematogenously

widespread loss of superficial epidermis

Loss of barrier function of the skin

S/Sx:
(+) fever Systemic Inflammatory Response of the body

S. aureus skin infection

Complications Signs and Symptoms

 Sepsis  Fussiness
 Cellulitis  Tiredness
 Severe infections  Redness of the skin
 Pneumonia  Fluid-filled blisters
 Nikolsky sign
 Sheet-like desquamation of skin
 Painful, erythematous rash with
wrinkled tissue paper life consistency