Staphylococcal scalded skin syndrome complicating acute generalized pustular psoriasis.
A 60-year-old woman with psoriasis vulgaris treated with oral cyclosporin and acitretin developed an acute generalized pustular eruption with erythema and associated fever consistent with acute generalized pustular psoriasis. She was admitted to hospital and, despite intravenous fluid replacement, developed acute renal failure. In addition, she developed staphylococcal septicaemia. After transfer to the intensive care unit because of deteriorating renal function, a sudden onset of widespread flaccid blistering (Nikolsky sign positive) and superficial erosions was noted. Histology of a biopsied blister revealed subcorneal splitting of the epidermis consistent with staphylococcal scalded skin syndrome. The patient was treated with intravenous dicloxacillin and the blistering gradually improved over 10 days.
Dermatology Department, Mater Misericordiae Hospital, South Brisbane, Queensland, Australia.
Michael P
MP
Sharkey
James B
JB
Muir
D000208:Acute Disease; D000368:Aged; D004009:Dicloxacillin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D011565:Psoriasis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D012872:Skin Diseases, Vesiculobullous / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D013206:Staphylococcal Scalded Skin Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D004009:Dicloxacillin