Skin Emergency Guide: SSSS, Impetigo Diagnosis and Treatment
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staphylococcus scalded skin syndrome impetigo TEN VS SSSS
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Skin Emergency Guide: SSSS, Impetigo Diagnosis and Treatment
- 1. Skin emergencies pedia DR ABDUL RUB SHERWANI ATTENDING CONSULTANT A&E
- 3. Staphylococcal scalded skin syndrome (SSSS) Bacterial agent is Staphylococcus aureus Toxin mediated disease Person to person transmission Nikolsky sign positive Desquamation in 3-5 days
- 4. Signs & Symptoms Skin appears burned (scalded) Other symptoms include malaise, irritability, fever; nose, mouth and genitalia may be painful
- 5. diagnosing Wound culture Toxin detection by PCR Xray chest Frozen section from skin-shows splits
- 6. isolation Fluids:20ml/kg as bolus Early antibiotics paracetamol Tropical wound care –fucidic acid/muprocin Steroids are avoided ,may worsen immune system NSAIDS may reduce renal function Intravenous immunoglobulins for prolonged stay Removal of dead skin
- 8. Impetigo (Pyoderma) Characterized by pus production Causative agents: Pyodermic cocci 80% cases caused by S. aureus Age group:2-6years Others caused by Streptococcus pyogenes Group A Streptococcus Gram-positive coccus, arranged in chains, β-hemolytic
- 9. Signs & Symptoms Superficial skin infection Blisters just below outer skin layer Blisters replaced by weepy yellow crust There is little fever or pain Lymph nodes enlarge near area May result in erysipelas
- 14. TEN VS SSSS
- 16. THANKS
Editor's Notes
- Less than 5 years age –fever followed by upper respiratory tract infection ,pharyngitis & conjunctivitis. Positive nikolesky sign
- Toxins exfolative /epidrmolytic –causing peeling of outer layer of skin & finally blister formation
- CXR to see pneumonia as primary cause of infection Wound culture from nose /conjectiva/axila
- Ten almost always mucous membrane is involved (mouth/conjectiva/trachea/esophagus/anus/vagin antibiotics-most are resistant to penicillin's –so start pencillin resistant synthetic pencillin –nafcillin/oxacallin & if MARSA is suspected vancomycin/linizolid should be given
- Baby recent visit to hospital –initially there was a blister then quickly brusts & leaves a cresty golden patch
- Highly contagious spread by direct contact ,minor abrasions predispose to infection
- Diagnosis is clinical ,blood cultures are needed somtimes
- Self limiting /avoid precipitating factors/
- EM- self limiting hypersensitivity reaction ,EM major>10% TBSA involved ..mcc HSV Types: SJS <10% TEN>30%