A Clinical Review of Staphylococcal Scalded Skin Syndrome for the Last 10 Years

ABSTRACT

OBJECTIVE: Staphylococcal scalded skin syndrome (4S) is not common, but has been increasingly recognized. We investigated the clinical features of 4S for the last 10 years. METHODS: This retrospective study was performed on 68 children who were admitted with 4S during 2001 to 2011. The patients were divided into 3 age groups or =48 months. We evaluated the clinical findings and the differences among the 3 age groups. RESULTS: The mean age was 32 months with a peak incidence at age 12 to 47 months. The peak incidence was observed in 2007 with a seasonal occurrence, mainly from July to October. Except 2007, there was no obvious seasonal pattern in incidence. Atopic dermatitis was combined in 10 patients (14.7%). By clinical types, 4 patients (5.9%) were in generalized type, 17 patients (25%) in intermediate type, and 47 patients (69.1%) in abortive type. The patients with generalized type were all neonates, and intermediate type was more frequent in children younger than 12 months. In contrast, abortive type was a most frequent form after 12 months of age. Of 44 patients performed skin culture, methicillin-resistant Staphylococcus aureus was isolated in 25 cases. All affected patients recovered completely with semi-synthetic penicillin or 3rd generation cephalosporins. Four neonates were treated with vancomycin or teicoplanin. CONCLUSION: The peak incidence of 4S was at age 12 to 47 months. The severity of 4S was most severe in children younger than 12 months, showing a difference in clinical types according to the age groups.