Abstract
We report a case of staphylococcal scalded skin syndrome (SSSS) in an adult. A 57-year-old woman with stupor and severe malnutrition developed diffuse erythema and edema on her face. Scaling and crusting then appeared in the perioral region. Erythroderma with exfoliation and erosion rapidly spread to her trunk and extremities. Nikolsky’s sign was positive. We used frozen-sections of a skin biopsy for rapid histological diagnosis of SSSS, which disclosed a cleavage in the upper layer of the epidermis. Methicillin-resistant Staphylococcus aureus was cultured from the skin, arterial blood, pharynx and everywhere else tested. She was successfully treated with intravenous arbekacin sulfate. The most important disease that should be diagnostically separated from SSSS in adults is drug-induced toxic epidermal necrolysis (TEN). Since standard treatments for SSSS and for drug-induced TEN are entirely different, dermatologists should acquire rapid and reliable procedures for histologically differentiating between these two diseases.
